Clinical Physiology of Circulation

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


Анатомическое обоснование трехмерных моделей корня аорты человека

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Link: Clinical Physiology of Blood Circulaiton. 2013; (): -

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Abstract

Objective. Construction of spatial three-dimensional computed models of the human aortic root on the basis of records received by the method of the multislice spiral computed tomoangiography and echocardiography.

Material and methods. The work has analysed the records received by transthoracic echocardiography. 117 patients were reported at the age of 18 to 81 years old with both the aortic valve insufficiency (regurgitation of 1st -4th stages, aortic stenosis of 1st-4th stages) (N=58) and without aortic insufficiency (N=59). For the purpose of volume visualization of sinuses of Valsalva the records of 20 patients without aortic valve insufficiency at the age of 60 to 65 years old who were examined by the coronary multislice spiral computed tomoangiography have been additionally analysed. On the basis of the records within the automatized designing we have constructed the three-dimensional models.

Results. In order to determine the main type-sizes the records of echocardiography were grouped depending on the diameter of the fibrous ring in diastole. The indication analysis in groups has shown the following reading for the diameter of fibrous ring: in group no.19 - 1.85±0.07 cm, in group no. 21 - 2.05±0.05 cm, no. 23 - 2.26±0.06 cm, no. 25 - 2.52±0.10 cm. Diameter of the sinotubular junction has made up: for group no.19 - 2.91±0.29 cm, no. 21 - 3.11±0.40 cm, no. 23 - 3.22±0.61 cm, no. 25 - 3.69±0.44 cm. There were no statistically significant differences between groups as for the distance from the fibrous ring to the sinotubular junction: 2.36 cm (quartile: 1.97 - 2.49 cm). The results of multislice spiral computed tomoangiography have not been grouped as during the statistical processing no correlation has been found between the diameter of the fibrous ring and such parameters as: 1) right (ρ=0.05) and left (ρ=0.02) angle of the socket of the ascending aorta, 2) distance from the fibrous ring to the orifice of right (ρ=0.27) and left (ρ=0.1) coronary arteries, 3) depth of sinuses of Valsalva (relatively of the right coronary cusp ρ=0.33; left coronary cusp ρ=0.19; non-coronary cusp ρ=0.02). Upon the results analysis of echocardiography and multislice spiral computed tomoangiography the four three-dimensional models of the human aortic root with diameter of fibrous ring of 19 mm, 21 mm, 23 mm and 25 mm have been created. 

Conclusion. As a result of the present research based on echocardiography and multislice spiral computed tomoangiography the four models of human aortic root have been received and grouped depending on the fibrous ring diameter. Models can be used for computer simulation of interaction between the valve prosthesis and the aorta. Such approach while developing the new types of prosthetic heart valves may simplify designing and predict potential risks and complications regarding implantation of such devices.

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