Khubulava G G, Marchenko S P, Starchik D A, Suvorov V V, Krivoshchekov E V, Shikhverdiev N N, Naumov A B
Cardiovascular Surgery Department, St. Petersburg State Pediatric Medical University of Healthcare Ministry of Russia.
Prives Department of Clinical Anatomy and Operative Surgery, Pavlov First St. Petersburg State Medical University.
Khirurgiia (Mosk). 2018(5):4-12. doi: 10.17116/hirurgia201854-12.
To assess linear and geometric parameters of the aortic valve and to determine the changes which are associated with impaired leaflets coaptation and aortic root enlargement.
Surgical anatomy of the aortic root and its spatial relationships with surrounding heart structures were studied with plastination by using of combined silicon technologies. 123 specimens of the aortic root with preserved original geometry were created with silicone plastination technique and perfusion embalming. Analysis included 15 heart specimens with the signs of aortic root dilatation and 108 specimens without evidence of dilatation. Multiple logistic regression was used for statistical analysis.
Anatomical and clinical analysis showed that deviation angle of the intercusp triangle is the factor contributing impaired aortic root geometry and aortic regurgitation (OR 1.3, 95% CI 1.114-1.350, p<0.0001).
评估主动脉瓣的线性和几何参数，并确定与瓣叶对合受损和主动脉根部扩大相关的变化。
采用联合硅技术塑化研究主动脉根部的手术解剖结构及其与周围心脏结构的空间关系。通过硅胶塑化技术和灌注防腐处理制备了123个保留原始几何形状的主动脉根部标本。分析包括15个有主动脉根部扩张迹象的心脏标本和108个无扩张证据的标本。采用多元逻辑回归进行统计分析。
解剖学和临床分析表明，瓣间三角的偏斜角是导致主动脉根部几何形状受损和主动脉瓣反流的因素（比值比1.3，95%可信区间1.114 - 1.350，p < 0.0001）。
1）瓣间三角偏斜角增大与主动脉瓣叶对合受损有关。2）将瓣间三角偏斜角恢复到1.7±1.2°在几何上是实现主动脉瓣正常功能所必需的。
