TY - JOUR

T1 - A New Look at Structural Changes in the Aortic Root in Aortic Valve Stenosis

AU - Kobelev, E.

AU - Bergen, T. A.

AU - Tarkova, A. R.

AU - Krestyaninov, O. V.

AU - Bobrikova, E. E.

AU - Safro, I. K.

AU - Chernyavsky, A. M.

AU - Zhuravleva, I. Yu

N1 - Kobelev E., Bergen T.A., Tarkova A.R., Krestyaninov O.V., Bobrikova E.E., Safro I.K., Chernyavsky A.M., Zhuravleva I.Yu. A new look at structural changes in the aortic root in aortic valve stenosis. Sovremennye tehnologii v medicine 2022; 14(2):51. Publisher Copyright: © 2022, Privolzhsky Research Medical University. All rights reserved.

PY - 2022

Y1 - 2022

N2 - The aim of the study was to identify new anatomical landmarks of the aortic root and the relationship between the sizes of anatomical structures using the method of computed tomography angiography to improve models of heart valves and the methods for their selection in clinical practice. Materials and Methods. The dataset of computed tomography angiography prior to aortic valve replacement in 262 patients was analyzed. The mean age was 75.0±5.9 years. 99 (37.8±3.0%) men and 163 (62.2±3.0%) women took part in the study. The annulus fibrosus, sinotubular junction, and height of the sinuses of Valsalva were measured. Results. In the tricuspid aortic valve group (n=251), in more than 50% of the cases, the diameter of the annulus fibrosus ranged from 23 to 26 mm. No significant association between the diameter of the annulus fibrosus and patient height (r=0.35; p=0.01) or body surface area (r=0.25; p=0.01) and the height of the sinuses of Valsalva (r=0.34; p=0.01) were revealed. Based on the ratio of the height of the sinuses of Valsalva and the diameter of the annulus fibrosus, three variants of the structure of the aortic root were identified: Type A — K>1.05; type B — 0.95≤K≤1.05; type C — K<0.95Type C of the aortic root was found to predominate in most cases, namely, in 98.0±0.9% (n=246). In the bicuspid aortic valve group (n=11), 2 patients had a type A valve, 1 patient had a type B valve, and 8 patients had a type C valve. Conclusion. A classification of variants of the aortic root structure has been proposed, which will be useful not only for practitioners when choosing a treatment method, but also for researchers to understand the structural characteristics of the aortic root in patients with its pathology.

AB - The aim of the study was to identify new anatomical landmarks of the aortic root and the relationship between the sizes of anatomical structures using the method of computed tomography angiography to improve models of heart valves and the methods for their selection in clinical practice. Materials and Methods. The dataset of computed tomography angiography prior to aortic valve replacement in 262 patients was analyzed. The mean age was 75.0±5.9 years. 99 (37.8±3.0%) men and 163 (62.2±3.0%) women took part in the study. The annulus fibrosus, sinotubular junction, and height of the sinuses of Valsalva were measured. Results. In the tricuspid aortic valve group (n=251), in more than 50% of the cases, the diameter of the annulus fibrosus ranged from 23 to 26 mm. No significant association between the diameter of the annulus fibrosus and patient height (r=0.35; p=0.01) or body surface area (r=0.25; p=0.01) and the height of the sinuses of Valsalva (r=0.34; p=0.01) were revealed. Based on the ratio of the height of the sinuses of Valsalva and the diameter of the annulus fibrosus, three variants of the structure of the aortic root were identified: Type A — K>1.05; type B — 0.95≤K≤1.05; type C — K<0.95Type C of the aortic root was found to predominate in most cases, namely, in 98.0±0.9% (n=246). In the bicuspid aortic valve group (n=11), 2 patients had a type A valve, 1 patient had a type B valve, and 8 patients had a type C valve. Conclusion. A classification of variants of the aortic root structure has been proposed, which will be useful not only for practitioners when choosing a treatment method, but also for researchers to understand the structural characteristics of the aortic root in patients with its pathology.

KW - 3D modeling of the aortic root

KW - Aortic stenosis

KW - Aortic valve

KW - Computed tomography

KW - Transcatheter aortic valve implantation

KW - Tomography, X-Ray Computed/methods

KW - Humans

KW - Male

KW - Aorta, Thoracic/pathology

KW - Aortic Valve Stenosis/diagnostic imaging

KW - Aorta/diagnostic imaging

KW - Aged, 80 and over

KW - Female

KW - Aged

KW - Aortic Valve/diagnostic imaging

UR - http://www.scopus.com/inward/record.url?scp=85133183189&partnerID=8YFLogxK

UR - https://www.elibrary.ru/item.asp?id=48504442

UR - https://www.mendeley.com/catalogue/759aa69e-ca19-353d-900e-797d6fb169c5/

U2 - 10.17691/stm2022.14.2.05

DO - 10.17691/stm2022.14.2.05

M3 - Article

C2 - 37065425

AN - SCOPUS:85133183189

VL - 14

SP - 51

EP - 56

JO - Современные технологии в медицине

JF - Современные технологии в медицине

SN - 2076-4243

IS - 2

M1 - 5

ER -