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

E. Kobelev, T. A. Bergen, A. R. Tarkova, O. V. Krestyaninov, E. E. Bobrikova, I. K. Safro, A. M. Chernyavsky, I. Yu Zhuravleva

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Translated title of the contributionНовый взгляд на структурные изменения корня аорты при стенозе аортального клапана
Original languageEnglish
Article number5
Pages (from-to)51-58
Number of pages8
JournalSovremennye Tehnologii v Medicine
Volume14
Issue number2
DOIs
Publication statusPublished - 2022
Externally publishedYes

Keywords

  • 3D modeling of the aortic root
  • Aortic stenosis
  • Aortic valve
  • Computed tomography
  • Transcatheter aortic valve implantation

OECD FOS+WOS

  • 1.06 BIOLOGICAL SCIENCES
  • 3.02 CLINICAL MEDICINE

State classification of scientific and technological information

  • 76.29 Clinical medicine

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