Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2024; 21 (4): 273-368 ➤ Функциональная реконструкция корня аорты: анатомия, биомеханика и гемодинамика

Functional reconstruction of the aortic root: biomechanics and hemodynamics

Authors: Alibekov D.-S.Ya.1, Ropova A.I.2, Savina E.D.2, Sinyavin G.V.2, Soborov M.A.1 2

Company:
1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2024-21-4-277-289

UDC: 616.132:[611+612.3]

Link: Clinical Physiology of Blood Circulaiton. 2024; 21 (4): 277-289

Quote as: Alibekov D.-S.Ya., Ropova A.I., Savina E.D., Sinyavin G.V., Soborov M.A. Functional reconstruction of the aortic root: biomechanics and hemodynamics. Clinical Physiology of Circulation. 2024; 21 (4): 277–289 (in Russ.). DOI: 10.24022/1814-6910-2024-21-4-277-289

Keywords:  aortic root aortic valve aortic valve biomechanics aortic root biomechanics aortic root hemodynamics spiral blood flow

Received / Accepted:  16.08.2024 / 15.11.2024

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Abstract

This paper reviews the actual topics of aortic root biomechanics and hemodynamics. The current concept of aortic root anatomy and histology is described. Physiological cyclical deformation of the aortic root is reviewed from the functional point of view. Such fundamental aspects of aortic hemodynamics as Windkessel effect, spiral blood flow and the role of vortical flow in the aortic sinuses where also mentioned. Described topics seem relevant for the problem of adequate aortic reconstruction.

References

  1. Benjamin E.J., Muntner P., Alonso A., Bittencourt M.S., Callaway C.W., Carson A.P. et al. Heart Disease and Stroke Statistics-2019 Update: a report from the American Heart Association. Circulation. 2019; 139 (10): e56–e528. DOI: 10.1161/CIR.0000000000000659
  2. Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J. et al. ESC/EACTS Scientific Document Group. 2021 ESC/ EACTS Guidelines for the management of valvular heart disease. Eur. Heart. J. 2022; 43 (7): 561–632. DOI: 10.1093/eurheartj/ehab395
  3. Yadgir S., Johnson C.O., Aboyans V., Adebayo O.M., Adedoyin R.A., Afarideh M. et al. Global, regional, and national burden of calcific aortic valve and degenerative mitral valve diseases, 1990–2017. Circulation. 2020; 141 (21): 1670–1680. DOI: 10.1161/CIRCULATIONAHA.119.043391
  4. Nkomo V.T., Gardin J.M., Skelton T.N., Gottdiener J.S., Scott C.G., Enriquez-Sarano M. Burden of valvular heart diseases: a population- based study. Lancet. 2006; 368 (9540): 1005–1011. DOI: 10.1016/S0140-6736(06)69208-8
  5. Anderson R.H. Clinical anatomy of the aortic root. Heart. 2000: 670–673. DOI: 10.1136/heart.84.6.670
  6. Anderson R.H., Devine W.A., Ho S.Y., Smith A., McKay R. The myth of the aortic annulus: the anatomy of the subaortic outflow tract. Ann. Thorac. Surg. 1991; 52 (3): 640–646. DOI: 10.1016/0003-4975(91)90966-t
  7. El Khoury G., Glineur D., Rubay J., Verhelst R., d’Acoz Yd., Poncelet A. et al. Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures. Curr. Opin. Cardiol. 2005; 20 (2): 115–121. DOI: 10.1097/01.hco.0000153951.31887.a6
  8. Tamás E., Nylander E. Echocardiographic description of the anatomic relations within the normal aortic root. J. Heart Valve Dis. 2007; 16(3): 240–246. PMID: 17578042.
  9. Anderson R.H. The surgical anatomy of the aortic root. Multimed. Man. Cardiothorac. Surg. 2007 1; 2007 (102): mmcts.2006.002527. DOI: 10.1510/mmcts.2006.002527
  10. Mori S., Anderson R.H., Tahara N., Izawa Y., Toba T., Fujiwara S. et al. The differences between bisecting and off-center cuts of the aortic root: The three-dimensional anatomy of the aortic root reconstructed from the living heart. Echocardiography. 2017; 34 (3): 453–461. DOI: 10.1111/echo.13468. Epub 2017 Feb 3.
  11. Barnard S.J., Haunschild J., Heiser L., Dieterlen M.T., Klaeske K., Borger M.A. et al. Apoptotic cell death in bicuspid-aortic-valve-associated aortopathy. Int. J. Mol. Sci. 2023; 24 (8): 7429. DOI: 10.3390/ijms24087429
  12. Berdajs D., Lajos P., Turina M. The anatomy of the aortic root. Cardiovasc. Surg. 2002; 10 (4): 320–327. DOI: 10.1016/s0967-2109(02)00018-2
  13. Choo S.J., McRae G., Olomon J.P., St George G., Davis W., Burleson-Bowles C.L. et al. Aortic root geometry: pattern of differences between leaflets and sinuses of Valsalva. J. Heart Valve Dis. 1999; 8 (4): 407–415. PMID: 10461241.
  14. Morbiducci U., Ponzini R., Rizzo G., Cadioli M., Esposito A., Montevecchi F.M. et al. Mechanistic insight into the physiological relevance of helical blood flow in the human aorta: an in vivo study. Biomech. Model. Mechanobiol. 2011; 10 (3): 339–355. DOI: 10.1007/s10237-010-0238-2. Epub 2010 Jul 22.
  15. Pisani G., Scaffa R., Ieropoli O., Dell’Amico E.M., Maselli D., Morbiducci U., De Paulis R. Role of the sinuses of Valsalva on the opening of the aortic valve. J. Thorac. Cardiovasc. Surg. 2013; 145 (4): 999–1003. DOI: 10.1016/j.jtcvs.2012.03.060. Epub 2012 Apr 13.
  16. Higashidate M., Tamiya K., Beppu T., Imai Y. Regulation of the aortic valve opening. In vivo dynamic measurement of aortic valve orifice area. J. Thorac. Cardiovasc. Surg. 1995; 110 (2): 496–503. DOI: 10.1016/S0022-5223(95)70246-6
  17. Brewer R.J., Deck J.D., Capati B., Nolan S.P. The dynamic aortic root. Its role in aortic valve function. J. Thorac. Cardiovasc. Surg. 1976; 72 (3): 413–417. PMID: 957758.
  18. Бритиков Д.В., Сачков А.С., Муратов Р.М. Функциональная анатомия, биомеханика и гемодинамика аортального клапана. Различные типы протезов в аортальной позиции. Клиническая физиология кровообращения. 2008: 2; 18–34.
  19. Brewer R.J., Mentzer R.M. Jr, Deck J.D., Ritter R.C., Trefil J.S., Nolan S.P. An in vivo study of the dimensional changes of the aortic valve leaflets during the cardiac cycle. J. Thorac. Cardiovasc. Surg. 1977; 74 (4): 645–650. PMID: 904366.
  20. Thubrikar M., Nolan S.P., Bosher L.P., Deck J.D. The cyclic changes and structure of the base of the aortic valve. Am. Heart J. 1980; 99 (2): 217–224. DOI: 10.1016/0002-8703(80)90768-1
  21. Cheng A., Dagum P., Miller D.C. Aortic root dynamics and surgery: from craft to science. Philos. Trans. R. Soc. Lond. B. Biol. Sci. 2007; 362 (1484): 1407–1419. DOI: 10.1098/rstb.2007.2124
  22. Dagum P., Green G.R., Nistal F.J., Daughters G.T., Timek T.A., Foppiano L.E. et al. Deformational dynamics of the aortic root: modes and physiologic determinants. Circulation. 1999; 100 (19 Suppl.): II54–62. DOI: 10.1161/01.cir.100.suppl_2.ii-54
  23. Bellhouse B.J. Fluid mechanics of the aortic valve. In: Baan J., Arntzenius A.C., Yellin E.L. (Eds) Cardiac Dynamics. Developments Cardiovasc. Med. 1980: 2; 489–496. DOI: 10.1007/978-94-009-8796-8_45
  24. Zimmerman J. The functional and surgical anatomy of the aortic valve. Isr. J. Med. Sci. 1969; 5 (4): 862–866. PMID: 5820535.
  25. Frank O. The basic shape of the arterial pulse. First treatise: mathematical analysis. 1899. J. Mol. Cell. Cardiol. 1990; 22 (3): 255–277. DOI: 10.1016/0022-2828(90)91460-o
  26. Mei C.C., Zhang J., Jing H.X. Fluid mechanics of Windkessel effect. Med. Biol. Eng. Comput. 2018; 56 (8): 1357–1366. DOI: 10.1007/s11517-017-1775-y. Epub 2018 Jan 8.
  27. Davies J.E., Parker K.H., Francis D.P., Hughes A.D., Mayet J. What is the role of the aorta in directing coronary blood flow? Heart. 2008; 94(12): 1545–1547. DOI: 10.1136/hrt.2008.144808
  28. Bremer J.L. The presence and influence of two spiral streams in the heart of the chick embryo. Am. J. Anat. 1932; 49 (3): 409–440. DOI: 10.1002/aja.1000490305
  29. Chandran K.B. Flow dynamics in the human aorta. J. Biomech. Eng. 1993; 115 (4B): 611–616. DOI: 10.1115/1.2895548
  30. Жоржолиани Ш.Т., Талыгин Е.А., Крашенинников С.В., Цыганков Ю.М., Агафонов А.В., Городков А.Ю. и др. Изменение упругости вдоль аорты как один из механизмов поддержания физиологически адекватной смерчеобразной структуры потока крови. Физиология человека. 2018; 5: 47–56. DOI: 10.1134/s013116461805017x
  31. Talygin E.A., Zhorzholiani S.T., Tkhagapsova M.M., Tsygankov Yu.M., Agafonov A.V., Gorodkov A.Yu. et al. Reconstruction of swirling blood flow in the heart and aorta on the basis of measurements of dynamic geometry and elastic properties of the flow channel. Proceedings of the ASME 2018 International Mechanical Engineering Congress and Exposition. Vol. 3: Biomedical and Biotechnology Engineering. Pittsburgh, Pennsylvania, USA. November 9–15, 2018. V003T04A052. ASME. DOI: 10.1115/imece2018-87680
  32. Багаев С.Н., Захаров В.Н., Орлов В.А. О необходимости винтового движения крови. Российский журнал биомеханики. 2002; 4: 30– 51.
  33. De Nisco G., Hoogendoorn A., Chiastra C., Gallo D., Kok A.M., Morbiducci U. et al. The impact of helical flow on coronary atherosclerotic plaque development. Atherosclerosis. 2020; 300: 39–46. DOI: 10.1016/j.atherosclerosis.2020.01.027. Epub 2020 Feb 7.
  34. Gallo D., Bijari P.B., Morbiducci U., Qiao Y., Xie Y.J., Etesami M. et al. Segment-specific associations between local haemodynamic and imaging markers of early atherosclerosis at the carotid artery: an in vivo human study. J. R. Soc. Interface. 2018; 15 (147): 20180352. DOI: 10.1098/rsif.2018.0352
  35. Mohamied Y., Rowland E.M., Bailey E.L., Sherwin S.J., Schwartz M.A., Weinberg P.D. Change of direction in the biomechanics of atherosclerosis. Ann. Biomed. Eng. 2015; 43 (1): 16–25. DOI: 10.1007/s10439-014-1095-4. Epub 2014 Aug 20.
  36. Сухачева Т.В., Пеняева Е.В., Соборов М.А., Гарманов С.В., Рычин С.В., Мироненко В.А. и др. Морфологические признаки ремоделирования стенки восходящей аорты и активизации регенераторного потенциала интимы при формировании аневризмы. Клеточные технологии в биологии и медицине. 2023; 1: 52–61. DOI: 10.47056/1814-3490-2023-1-52-61
  37. Morbiducci U., Ponzini R., Rizzo G., Cadioli M., Esposito A., De Cobelli F. et al. In vivo quantification of helical blood flow in human aorta by time-resolved three-dimensional cine phase contrast magnetic resonance imaging. Ann. Biomed. Eng. 2009; 37 (3): 516–531. DOI: 10.1007/s10439-008-9609-6. Epub 2008 Dec 6.
  38. Kilner P.J., Yang G.Z, Mohiaddin R.H., Firmin D.N., Longmore D.B. Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation. 1993; 88 (5, Pt 1): 2235–2247. DOI: 10.1161/01.cir.88.5.2235
  39. Tanaka M., Sakamoto T., Sugawara S., Nakajima H., Kameyama T., Katahira Y. et al. Spiral systolic blood flow in the ascending aorta and aortic arch analyzed by echodynamography. J. Cardiol. 2010; 56 (1): 97–110. DOI: 10.1016/j.jjcc.2010.03.008. Epub 2010 May 13.
  40. Hansen K.L., Møller-Sørensen H., Pedersen M.M., Hansen P.M., Kjaergaard J., Lund J.T. et al. First report on intraoperative vector flow imaging of the heart among patients with healthy and diseased aortic valves. Ultrasonics. 2015; 56: 243–250. DOI: 10.1016/j.ultras.2014.07.015. Epub 2014 Aug 1.
  41. Hansen K.L., Møller-Sørensen H., Kjaergaard J., Jensen M.B., Lund J.T., Pedersen M.M. et al. Analysis of systolic backflow and secondary helical blood flow in the ascending aorta using vector flow imaging. Ultrasound. Med. Biol. 2016; 42 (4): 899–908. DOI: 10.1016/j.ultrasmedbio.2015.11.029. Epub 2016 Jan 13.
  42. Кикнадзе Г.И., Краснов Ю.К., Хабенский В.Б. Самоорганизация вихревых структур при обтекании водой сферической лунки. Доклады Академии наук СССР. 1986; 291 (6): 1315.
  43. Bockeria L.A., Kiknadze G.I., Agafonov A.V., Gachechiladze I.A., Gorodkov A.Yu. Application of tornado-flow fundamental hydrodynamic theory to the study of blood flow in the heart and main vessels: design of new implantable and accessory devices for cardiovascular surgery. In: ASME International Mechanical Engineering Congress and Exposition. Vol. 45189. American Society of Mechanical Engineers, 2012. DOI: 10.1115/IMECE2012-87403
  44. Мироненко В.А., Соборов М.А., Городков А.Ю., Бокерия Л.А. Особенности кровотока в аорте как критерий эффективности реконструктивных вмешательств. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2021; 5 (22): 508–514. DOI: 10.24022/1810-0694-2021-22-5-508-514
  45. Мироненко М.Ю., Муратов Р.М., Мироненко В.А., Тхашокова Л.Р., Голухова Е.З. Трехмерная чреспищеводная эхокардиография при планировании реконструктивных вмешательств на аортальном клапане. Креативная кардиология. 2023; 17 (2): 279–295. DOI: 10.24022/1997-3187-2023-17-2-279-295
  46. Бакулева Н.П., Мироненко В.А., Рычин С.В., Салохединова Р.Р., Фадеев А.А. Клапансодержащий синтетический кондуит для протезирования восходящей аорты: в поисках оптимальных решений. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. Сердечно- сосудистые заболевания. 2023; 24 (5): 434–444. DOI: 10.24022/1810-0694-2023-24-5-434-444
****
  1. Benjamin E.J., Muntner P., Alonso A., Bittencourt M.S., Callaway C.W., Carson A.P. et al. Heart Disease and Stroke Statistics-2019 Update: a report from the American Heart Association. Circulation. 2019; 139 (10): e56–e528. DOI: 10.1161/CIR.0000000000000659
  2. Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J. et al. ESC/EACTS Scientific Document Group. 2021 ESC/ EACTS Guidelines for the management of valvular heart disease. Eur. Heart. J. 2022; 43 (7): 561–632. DOI: 10.1093/eurheartj/ehab395
  3. Yadgir S., Johnson C.O., Aboyans V., Adebayo O.M., Adedoyin R.A., Afarideh M. et al. Global, regional, and national burden of calcific aortic valve and degenerative mitral valve diseases, 1990–2017. Circulation. 2020; 141 (21): 1670–1680. DOI: 10.1161/CIRCULATIONAHA.119.043391
  4. Nkomo V.T., Gardin J.M., Skelton T.N., Gottdiener J.S., Scott C.G., Enriquez-Sarano M. Burden of valvular heart diseases: a population- based study. Lancet. 2006; 368 (9540): 1005–1011. DOI: 10.1016/S0140-6736(06)69208-8
  5. Anderson R.H. Clinical anatomy of the aortic root. Heart. 2000: 670–673. DOI: 10.1136/heart.84.6.670
  6. Anderson R.H., Devine W.A., Ho S.Y., Smith A., McKay R. The myth of the aortic annulus: the anatomy of the subaortic outflow tract. Ann. Thorac. Surg. 1991; 52 (3): 640–646. DOI: 10.1016/0003-4975(91)90966-t
  7. El Khoury G., Glineur D., Rubay J., Verhelst R., d’Acoz Yd., Poncelet A. et al. Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures. Curr. Opin. Cardiol. 2005; 20 (2): 115–121. DOI: 10.1097/01. hco.0000153951.31887.a6
  8. Tamás E., Nylander E. Echocardiographic description of the anatomic relations within the normal aortic root. J. Heart Valve Dis. 2007; 16(3): 240–246. PMID: 17578042.
  9. Anderson R.H. The surgical anatomy of the aortic root. Multimed. Man. Cardiothorac. Surg. 2007 1; 2007 (102): mmcts.2006.002527. DOI: 10.1510/mmcts.2006.002527
  10. Mori S., Anderson R.H., Tahara N., Izawa Y., Toba T., Fujiwara S. et al. The differences between bisecting and off-center cuts of the aortic root: The three-dimensional anatomy of the aortic root reconstructed from the living heart. Echocardiography. 2017; 34 (3): 453–461. DOI: 10.1111/echo.13468. Epub 2017 Feb 3.
  11. Barnard S.J., Haunschild J., Heiser L., Dieterlen M.T., Klaeske K., Borger M.A. et al. Apoptotic cell death in bicuspid-aortic-valve-associated aortopathy. Int. J. Mol. Sci. 2023; 24 (8): 7429. DOI: 10.3390/ijms24087429
  12. Berdajs D., Lajos P., Turina M. The anatomy of the aortic root. Cardiovasc. Surg. 2002; 10 (4): 320–327. DOI: 10.1016/s0967-2109(02)00018-2
  13. Choo S.J., McRae G., Olomon J.P., St George G., Davis W., Burleson-Bowles C.L. et al. Aortic root geometry: pattern of differences between leaflets and sinuses of Valsalva. J. Heart Valve Dis. 1999; 8 (4): 407–415. PMID: 10461241.
  14. Morbiducci U., Ponzini R., Rizzo G., Cadioli M., Esposito A., Montevecchi F.M. et al. Mechanistic insight into the physiological relevance of helical blood flow in the human aorta: an in vivo study. Biomech. Model. Mechanobiol. 2011; 10 (3): 339–355. DOI: 10.1007/s10237-010-0238-2. Epub 2010 Jul 22.
  15. Pisani G., Scaffa R., Ieropoli O., Dell’Amico E.M., Maselli D., Morbiducci U., De Paulis R. Role of the sinuses of Valsalva on the opening of the aortic valve. J. Thorac. Cardiovasc. Surg. 2013; 145 (4): 999–1003. DOI: 10.1016/j.jtcvs.2012.03.060. Epub 2012 Apr 13.
  16. Higashidate M., Tamiya K., Beppu T., Imai Y. Regulation of the aortic valve opening. In vivo dynamic measurement of aortic valve orifice area. J. Thorac. Cardiovasc. Surg. 1995; 110 (2): 496–503. DOI: 10.1016/S0022-5223(95)70246-6
  17. Brewer R.J., Deck J.D., Capati B., Nolan S.P. The dynamic aortic root. Its role in aortic valve function. J. Thorac. Cardiovasc. Surg. 1976; 72 (3): 413–417. PMID: 957758.
  18. Britikov D.V., Sachkov A.S., Muratov R.M. Functional anatomy, biomechanics and hemodynamics of the aortic valve. Various types of prostheses in the aortic position. Clinical Physiology of Circulation. 2008; 2: 18–34 (in Russ.).
  19. Brewer R.J., Mentzer R.M. Jr, Deck J.D., Ritter R.C., Trefil J.S., Nolan S.P. An in vivo study of the dimensional changes of the aortic valve leaflets during the cardiac cycle. J. Thorac. Cardiovasc. Surg. 1977; 74 (4): 645–650. PMID: 904366.
  20. Thubrikar M., Nolan S.P., Bosher L.P., Deck J.D. The cyclic changes and structure of the base of the aortic valve. Am. Heart J. 1980; 99 (2): 217–224. DOI: 10.1016/0002-8703(80)90768-1
  21. Cheng A., Dagum P., Miller D.C. Aortic root dynamics and surgery: from craft to science. Philos. Trans. R. Soc. Lond. B. Biol. Sci. 2007; 362 (1484): 1407–1419. DOI: 10.1098/rstb.2007.2124
  22. Dagum P., Green G.R., Nistal F.J., Daughters G.T., Timek T.A., Foppiano L.E. et al. Deformational dynamics of the aortic root: modes and physiologic deter minants. Circulation. 1999; 100 (19 Suppl.): II54–62. DOI: 10.1161/01.cir.100.suppl_2.ii-54
  23. Bellhouse B.J. Fluid mechanics of the aortic valve. In: Baan J., Arntzenius A.C., Yellin E.L. (Eds) Cardiac Dynamics. Developments Cardiovasc. Med. 1980: 2; 489–496. DOI: 10.1007/978-94-009-8796-8_45
  24. Zimmerman J. The functional and surgical anatomy of the aortic valve. Isr. J. Med. Sci. 1969; 5 (4): 862–866. PMID: 5820535.
  25. Frank O. The basic shape of the arterial pulse. First treatise: mathematical analysis. 1899. J. Mol. Cell. Cardiol. 1990; 22 (3): 255–277. DOI: 10.1016/0022-2828(90)91460-o
  26. Mei C.C., Zhang J., Jing H.X. Fluid mechanics of Windkessel effect. Med. Biol. Eng. Comput. 2018; 56 (8): 1357–1366. DOI: 10.1007/s11517-017-1775-y. Epub 2018 Jan 8.
  27. Davies J.E., Parker K.H., Francis D.P., Hughes A.D., Mayet J. What is the role of the aorta in directing coronary blood flow? Heart. 2008; 94(12): 1545–1547. DOI: 10.1136/hrt.2008.144808
  28. Bremer J.L. The presence and influence of two spiral streams in the heart of the chick embryo. Am. J. Anat. 1932; 49 (3): 409–440. DOI: 10.1002/aja.1000490305
  29. Chandran K.B. Flow dynamics in the human aorta. J. Biomech. Eng. 1993; 115 (4B): 611–616. DOI: 10.1115/1.2895548
  30. Zhorzholiani S.T., Talygin E.A., Krasheninnikov S.V., Tsigankov Y.M., Agafonov A.V., Gorodkov A.Yu. et al. Elasticity change along the aorta is a mechanism for supporting the physiological self-organization of tornado-like blood flow. Human Physiology. 2018; 5: 47–56 (in Russ.). DOI: 10.1134/s013116461805017x
  31. Talygin E.A., Zhorzholiani S.T., Tkhagapsova M.M., Tsygankov Yu.M., Agafonov A.V., Gorodkov A.Yu. et al. Reconstruction of swirling blood flow in the heart and aorta on the basis of measurements of dynamic geometry and elastic properties of the flow channel. Proceedings of the ASME 2018 International Mechanical Engineering Congress and Exposition. Vol. 3: Biomedical and Biotechnology Engineering. Pittsburgh, Pennsylvania, USA. November 9–15, 2018. V003T04A052. ASME. DOI: 10.1115/imece2018-87680
  32. Bagaev S.N., Zakharov V.N., Orlov V.A. The need for a spiral movement of blood. Russian Journal of Biomechanics. 2002; 4: 30–51 (in Russ.).
  33. De Nisco G., Hoogendoorn A., Chiastra C., Gallo D., Kok A.M., Morbiducci U. et al. The impact of helical flow on coronary atherosclerotic plaque development. Atherosclerosis. 2020; 300: 39–46. DOI: 10.1016/j.atherosclerosis.2020.01.027. Epub 2020 Feb 7.
  34. Gallo D., Bijari P.B., Morbiducci U., Qiao Y., Xie Y.J., Etesami M. et al. Segment-specific associations between local haemodynamic and imaging markers of early atherosclerosis at the carotid artery: an in vivo human study. J. R. Soc. Interface. 2018; 15 (147): 20180352. DOI: 10.1098/rsif.2018.0352
  35. Mohamied Y., Rowland E.M., Bailey E.L., Sherwin S.J., Schwartz M.A., Weinberg P.D. Change of direction in the biomechanics of atherosclerosis. Ann. Biomed. Eng. 2015; 43 (1): 16–25. DOI: 10.1007/s10439-014-1095-4. Epub 2014 Aug 20.
  36. Sukhacheva T.V., Penyaeva E.V., Soborov M.A., Garmanov S.V., Rychin S.V., Mironenko V.A. et al. Morphological features of the ascending aorta remodeling and activation of regeneratory potential in intima when forming aneurysm. Cellular Technologies in Biology and Medicine. 2023; 175 (1): 52–61 (in Russ.). DOI: 10.47056/1814-3490-2023-1-52-61
  37. Morbiducci U., Ponzini R., Rizzo G., Cadioli M., Esposito A., De Cobelli F. et al. In vivo quantification of helical blood flow in human aorta by time-resolved three-dimensional cine phase contrast magnetic resonance imaging. Ann. Biomed. Eng. 2009; 37 (3): 516–531. DOI: 10.1007/s10439-008-9609-6. Epub 2008 Dec 6.
  38. Kilner P.J., Yang G.Z, Mohiaddin R.H., Firmin D.N., Longmore D.B. Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation. 1993; 88 (5, Pt 1): 2235–2247. DOI: 10.1161/01.cir.88.5.2235
  39. Tanaka M., Sakamoto T., Sugawara S., Nakajima H., Kameyama T., Katahira Y. et al. Spiral systolic blood flow in the ascending aorta and aortic arch analyzed by echodynamography. J. Cardiol. 2010; 56 (1): 97–110. DOI: 10.1016/j.jjcc.2010.03.008. Epub 2010 May 13.
  40. Hansen K.L., Møller-Sørensen H., Pedersen M.M., Hansen P.M., Kjaergaard J., Lund J.T. et al. First report on intraoperative vector flow imaging of the heart among patients with healthy and diseased aortic valves. Ultrasonics. 2015; 56: 243–250. DOI: 10.1016/j.ultras.2014.07.015. Epub 2014 Aug 1.
  41. Hansen K.L., Møller-Sørensen H., Kjaergaard J., Jensen M.B., Lund J.T., Pedersen M.M. et al. Analysis of systolic backflow and secondary helical blood flow in the ascending aorta using vector flow imaging. Ultrasound. Med. Biol. 2016; 42 (4): 899–908. DOI: 10.1016/j.ultrasmedbio.2015.11.029. Epub 2016 Jan 13.
  42. Kiknadze G.I., Krasnov Yu.K., Khabensky V.B. Self-organization of vortex structures during water flow around a spherical well. Reports of the USSR Academy of Sciences. 1986; 291 (6): 1315 (in Russ.).
  43. Bockeria L.A., Kiknadze G.I., Agafonov A.V., Gachechiladze I.A., Gorodkov A.Yu. Application of tornado-flow fundamental hydrod ynamic theory to the study of blood flow in the heart and main vessels: design of new implantable and accessory devices for cardiovascular surgery. In: ASME International Mechanical Engineering Congress and Exposition. Vol. 45189. American Society of Mechanical Engineers, 2012. DOI: 10.1115/IMECE2012-87403
  44. Mironenko V.A., Soborov M.A., Gorodkov A.Yu., Bockeria L.A. Features of blood flow in the aorta as a criterion for the effectiveness of reconstructive interventions. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2021; 5 (22): 508–514 (in Russ.). DOI: 10.24022/1810- 0694-2021-22-5-508-514
  45. Mironenko M.Yu., Muratov R.M., Mironenko V.A., Tkhashokova L.R., Golukhova E.Z. Three-dimensional transesophageal echocardiography in the planning of reconstructive interventions on the aortic valve. Creative Cardiology. 2023; 17 (2): 279–295 (in Russ.). DOI: 10.24022/1997-3187-2023-17-2-279-295
  46. Bakuleva N.P., Mironenko V.A., Rychin S.V., Salokhedinova R.R., Fadeev A.A. Valve-containing synthetic vascular graft for ascending aorta replacement: in search for optimal solutions. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2023; 24 (5): 434–444 (in Russ.). DOI: 10.24022/1810-0694-2023-24-5-434-444

About Authors

  • Deni-Sultan Ya. Alibekov, Resident; ORCID
  • Anna I. Ropova, Resident; ORCID
  • Elizaveta D. Savina, Student; ORCID
  • Gennadiy V. Sinyavin, Dr. Med. Sci., Cardiovascular Surgeon; ORCID
  • Mark A. Soborov, Cand. Med. Sci., Cardiovascular Surgeon; ORCID

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