kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2025-14-1-91-102kpccz-1162Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Сердечно-сосудистая хирургияREVIEWS. Cardiovascular surgeryХИРУРГИЧЕСКАЯ АНАТОМИЯ КОРНЯ АОРТЫ В АСПЕКТЕ ЕГО РЕКОНСТРУКЦИИSURGICAL ANATOMY OF THE AORTIC ROOT IN THE ASPECT OF ITS RECONSTRUCTIONhttps://orcid.org/0000-0002-0476-2120НогиновВладимир КонстантиновичNoginovVladimir K.

ассистент кафедры оперативной хирургии и топографической анатомии имени проф. Ф.И. Валькера федерального государственного бюджетного образовательного учреждения высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской Федерации, Санкт-Петербург, Российская Федерация; врач – сердечно-сосудистый хирург кардиохирургического отделения государственного бюджетного учреждения здравоохранения «Ленинградская областная клиническая больница», Санкт-Петербург, Российская Федерация

Assistant Professor at the Department of Operative Surgery and Topographic Anatomy named after Professor F. I. Walker of the Federal State Budgetary Educational Institution of Higher Education "St. Petersburg State Pediatric Medical University" of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation; cardiovascular surgeon at the Cardiac Surgery Department of the State Budgetary Healthcare Institution "Leningrad Regional Clinical Hospital hospital", Saint Petersburg, Russian Federation

mrnoginov@mail.ruhttps://orcid.org/0000-0002-3904-6415КомаровРоман НиколаевичKomarovRoman N.

доктор медицинских наук, профессор заведующий кафедрой факультетской хирурги № 1 Института клинической медицины им. Н.В. Склифосовского федерального государственного автономного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

PhD, MD, Professor, Head of the Department of Faculty Surgery No. 1 of the N. V. Sklifosovsky Institute of Clinical Medicine of the Federal State Autonomous Educational Institution of Higher Education "I.M. Sechenov First Moscow State Medical University" of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation

komarovroman@rambler.ruhttps://orcid.org/0000-0001-5311-1802БагатурияГеоргий ОтаровичBagaturiaGeorgy O.

доктор медицинских наук, профессор заведующий кафедрой оперативной хирургии и топографической анатомии имени проф. Ф.И. Валькера федерального государственного бюджетного образовательного учреждения высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской Федерации, Санкт-Петербург, Российская Федерация

PhD, MD, Professor, Head of the Department of Operative Surgery and Topographic Anatomy named after Prof. F.I. Walker Federal State Budgetary Educational Institution of Higher Education "St. Petersburg State Pediatric Medical University" of the Ministry of Health of the Russian Federation, St. Petersburg, Russian Federation

geobag@mail.ruhttps://orcid.org/0000-0002-1564-9182ДзюндзяАндрей НиколаевичDzyunjaAndrey N.

врач – сердечно-сосудистый хирург федерального государственного автономного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

Cardiovascular Surgeon, Federal State Autonomous Educational Institution of Higher Education "I.M. Sechenov First Moscow State Medical University", Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation

dzyundzya@mail.ruhttps://orcid.org/0000-0002-9671-9524ЛенковецМаринаLenkovetsMarina

врач – сердечно-сосудистый хирург, аспирант кафедры факультетской хирурги № 1 Института клинической медицины им. Н.В. Склифосовского федерального государственного автономного образовательного учреждения высшего образования «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

Cardiovascular surgeon, Postgraduate student at the Department of Faculty Surgery No. 1 of the N.V. Sklifosovsky Institute of Clinical Medicine of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation

MarynaLenkovets@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской Федерации; Государственное бюджетное учреждение здравоохранения «Ленинградская областная клиническая больницаРоссияFederal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” of the Ministry of Health of the Russian Federation; State Budgetary Healthcare Institution Leningrad Regional Clinical HospitalRussian FederationФедеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education “I.M. Sechenov First Moscow State Medical University” of the Ministry of Health of the Russian FederationRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный педиатрический медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Saint Petersburg State Pediatric Medical University” of the Ministry of Health of the Russian FederationRussian Federation20252802202514191102Copyright © Ногинов В.К., Комаров Р.Н., Багатурия Г.О., Дзюндзя А.Н., Ленковец М., 20252025Ногинов В.К., Комаров Р.Н., Багатурия Г.О., Дзюндзя А.Н., Ленковец М.Noginov V.K., Komarov R.N., Bagaturia G.O., Dzyunja A.N., Lenkovets M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1162Основные положения

Основные положения

Представлены анатомо-топографические особенности корня аорты, знание которых необходимо для его успешной реконструкции.

 

 

Резюме

Резюме

Цель настоящего литературного обзора включала изучение и определение анатомических особенностей строения, структур и топографии корня аорты в перспективе реконструктивного хирургического подхода в лечении проксимального отдела грудной аорты. Проанализированы анатомия и топография корня аорты у неоперированных пациентов, у лиц без признаков дилатации с использованием лучевых, функциональных методов диагностики, а также исследования, проведенные на препаратах сердца, полученных от пациентов, умерших от внесердечных причин. Рассмотрены хирургические особенности выполнения реконструктивных вмешательств на корне аорты с учетом его анатомии. Область корня аорты анатомически изменчива, зависит от антропометрических данных, расовой принадлежности, пола и др. Для успешного выполнения реконструкции корня аорты необходимо достичь определенных индексированных значений между его структурами. Абсолютные знания и понимание хирургической анатомии корня аорты необходимы для успешного выполнения его реконструкции.

Highlights

Highlights

The presented literature review contains anatomical and topographic features of the aortic root, knowledge of which is necessary for its successful reconstruction.

 

 

Abstract

Abstract

The purpose of this literature review is to study and determine the anatomical features of the structures and topography of the aortic root in the perspective of a reconstructive surgical approach in the treatment of the proximal thoracic aorta. A review was conducted on the anatomy and topography of the aortic root in non-operated patients, without signs of its dilation using radiation, functional diagnostic methods, as well as studies conducted on heart preparations obtained from patients who died of non-cardiac causes. The surgical features of performing reconstructive interventions on the aortic root, taking into account the peculiarities of its anatomy, are also considered. The area of the aortic root is anatomically variable, depending on anthropometric data, race, gender, etc. To successfully perform the reconstruction of the aortic root, it is necessary to achieve certain indexed values between its structures. Absolute knowledge and understanding of the surgical anatomy of the aortic root are necessary for the successful implementation of its reconstruction.

Корень аортыХирургическая анатомияКлапаносохраняющая замена корня аортыАортальный клапанAortic rootSurgical anatomyValve-sparing aortic root replacementAortic valveАвторы заявляют об отсутствии финансирования исследования.ReferencesDe Paulis R., Salica A. Surgical anatomy of the aortic valve and root-implications for valve repair. Annals of cardiothoracic surgery. 2019 May;8(3):313-321. doi: 10.21037/acs.2019.04.16. PMID: 31240175De Paulis R., Salica A. Surgical anatomy of the aortic valve and root-implications for valve repair. Annals of cardiothoracic surgery. 2019 May;8(3):313-321. doi: 10.21037/acs.2019.04.16. PMID: 31240175Paiocchi V.L., Faletra F.F., Ferrari E., Schlossbauer S.A., Leo L.A., Maisano F.. Multimodality imaging of the anatomy of the aortic root. Journal of cardiovascular development and disease. 2021 May 4;8(5):51. PMID: 34064421. doi: 10.3390/jcdd8050051Paiocchi V.L., Faletra F.F., Ferrari E., Schlossbauer S.A., Leo L.A., Maisano F.. Multimodality imaging of the anatomy of the aortic root. Journal of cardiovascular development and disease. 2021 May 4;8(5):51. PMID: 34064421. doi: 10.3390/jcdd8050051Irace F.G., Chirichilli I., Salica A., D’Aleo S., Wolf L.G., Garufi L., De Paulis R.. Aortic root anatomy after aortic valve reimplantation. The journal of thoracic and cardiovascular surgery. 2021 Apr 16;S0022-5223(21)00695-4. PMID: 33985805. DOI: 10.1016/j.jtcvs.2021.03.115.Irace F.G., Chirichilli I., Salica A., D’Aleo S., Wolf L.G., Garufi L., De Paulis R.. Aortic root anatomy after aortic valve reimplantation. The journal of thoracic and cardiovascular surgery. 2021 Apr 16;S0022-5223(21)00695-4. PMID: 33985805. DOI: 10.1016/j.jtcvs.2021.03.115.Almoosawy. S.A., Lucka P., Cummine R., Buchan K.. The aortic root hexagon as an aide memoire to the important surgical landmarks. Clinical anatomy. 2020 Nov;33(8):1228-1234. PMID: 31983068. DOI: 10.1002/ca.23571Almoosawy. S.A., Lucka P., Cummine R., Buchan K.. The aortic root hexagon as an aide memoire to the important surgical landmarks. Clinical anatomy. 2020 Nov;33(8):1228-1234. PMID: 31983068. DOI: 10.1002/ca.23571Lansac E., Lim H-S., Shomura Y., Lim K.H., Rice N.T., Di Centa I., Youssefi P., Goetz W., Doran C.M.G.. Aortic valve opening and closure: the clover dynamics. Annals of cardiothoracic surgery. 2019 May;8(3):351-361. PMID: 31240179. DOI: 10.21037/acs.2019.05.03.Lansac E., Lim H-S., Shomura Y., Lim K.H., Rice N.T., Di Centa I., Youssefi P., Goetz W., Doran C.M.G.. Aortic valve opening and closure: the clover dynamics. Annals of cardiothoracic surgery. 2019 May;8(3):351-361. PMID: 31240179. DOI: 10.21037/acs.2019.05.03.Koshkelashvili N., Bucay M.J., Goykhman I., Pressman G.S.. Aortic root and valve proportions: an example of the golden ratio? Monaldi archives for chest disease. 2019 Jul 15;89(2). PMID: 31315350. DOI: 10.4081/monaldi.2019.1022.Koshkelashvili N., Bucay M.J., Goykhman I., Pressman G.S.. Aortic root and valve proportions: an example of the golden ratio? Monaldi archives for chest disease. 2019 Jul 15;89(2). PMID: 31315350. DOI: 10.4081/monaldi.2019.1022.Wang X., Ren X-S., An Y-Q., Hou Z-H., Yu Y-T., Lu B., Wang F.. A specific assessment of the normal anatomy of the aortic root in relation to age and gender. International journal of general medicine. 2021 Jun 25;14:2827-2837. PMID: 34234516. DOI: 10.2147/IJGM.S312439Wang X., Ren X-S., An Y-Q., Hou Z-H., Yu Y-T., Lu B., Wang F.. A specific assessment of the normal anatomy of the aortic root in relation to age and gender. International journal of general medicine. 2021 Jun 25;14:2827-2837. PMID: 34234516. DOI: 10.2147/IJGM.S312439Petersen J., Voigtlander L., Schofer N., Neumann N., von Kodolitsch Y., Reichenspurner H., Girdauskas E.. Geometric changes in the aortic valve annulus during the cardiac cycle: impact on aortic valve repair. European journal of cardio-thoracic surgery. 2018 Sep 1;54(3):441-445. PMID: 29514226. DOI: 10.1093/ejcts/ezy099Petersen J., Voigtlander L., Schofer N., Neumann N., von Kodolitsch Y., Reichenspurner H., Girdauskas E.. Geometric changes in the aortic valve annulus during the cardiac cycle: impact on aortic valve repair. European journal of cardio-thoracic surgery. 2018 Sep 1;54(3):441-445. PMID: 29514226. DOI: 10.1093/ejcts/ezy099Yacoub M.H., Aguib H., Gamrah M.A., Shehata N., Nagy M., Donia M., Aguib Y., Saad H., Romeih S., Torii R., Afifi A., Lee. S-L.. Aortic root dynamism, geometry, and function after the remodeling operation: Clinical relevance. The Journal of thoracic and cardiovascular surgery. 2018 Sep;156(3):951-962.e2. PMID: 29884493. DOI: 10.1016/j.jtcvs.2018.03.157.Yacoub M.H., Aguib H., Gamrah M.A., Shehata N., Nagy M., Donia M., Aguib Y., Saad H., Romeih S., Torii R., Afifi A., Lee. S-L.. Aortic root dynamism, geometry, and function after the remodeling operation: Clinical relevance. The Journal of thoracic and cardiovascular surgery. 2018 Sep;156(3):951-962.e2. PMID: 29884493. DOI: 10.1016/j.jtcvs.2018.03.157.O’Brien, B.; Zafar, H.; De Freitas, S.; Sharif, F. Transseptal Puncture—Review of Anatomy, Techniques, Complications and Challenges. International journal of cardiology. 2017 Apr 15;233:12-22. PMID: 28202256. doi: 10.1016/j.ijcard.2017.02.009O’Brien, B.; Zafar, H.; De Freitas, S.; Sharif, F. Transseptal Puncture—Review of Anatomy, Techniques, Complications and Challenges. International journal of cardiology. 2017 Apr 15;233:12-22. PMID: 28202256. doi: 10.1016/j.ijcard.2017.02.009El Khoury G., Glineur D., Rubay J., Verhelst R., d'Udekem d'Acoz Y., Poncelet A., Astarci P., Noirhomme Ph., van Dyck M.. Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures. Current opinion in cardiology. 2005 Mar;20(2):115-21. PMID: 15711197. doi: 10.1097/01.hco.0000153951.31887.a6El Khoury G., Glineur D., Rubay J., Verhelst R., d'Udekem d'Acoz Y., Poncelet A., Astarci P., Noirhomme Ph., van Dyck M.. Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures. Current opinion in cardiology. 2005 Mar;20(2):115-21. PMID: 15711197. doi: 10.1097/01.hco.0000153951.31887.a6Kunihara T. Anatomy of the aortic root: implications for aortic root reconstruction. General thoracic and cardiovascular surgery. 2017 Sep;65(9):488-499. PMID: 28656518. DOI: 10.1007/s11748-017-0792-yKunihara T. Anatomy of the aortic root: implications for aortic root reconstruction. General thoracic and cardiovascular surgery. 2017 Sep;65(9):488-499. PMID: 28656518. DOI: 10.1007/s11748-017-0792-yMori S., Izawa Y., Shimoyama S., Tretter J.T.. Three-Dimensional Understanding of Complexity of the Aortic Root Anatomy as the Basis of Routine Two-Dimensional Echocardiographic Measurements. Circulation journal. 2019 Oct 25;83(11):2320-2323. PMID: 31511440. DOI: 10.1253/circj.CJ-19-0652Mori S., Izawa Y., Shimoyama S., Tretter J.T.. Three-Dimensional Understanding of Complexity of the Aortic Root Anatomy as the Basis of Routine Two-Dimensional Echocardiographic Measurements. Circulation journal. 2019 Oct 25;83(11):2320-2323. PMID: 31511440. DOI: 10.1253/circj.CJ-19-0652Toh H., Mori S., Tretter J.T., Izawa Y., Shimoyama S., Suzuki M., Takahashi Y., Tsuda D., Toba T., Fujiwara S., Hirata K., Anderson R.H.. Living Anatomy of the Ventricular Myocardial Crescents Supporting the Coronary Aortic Sinuses. Seminars in thoracic and cardiovascular surgery. 2020 Summer;32(2):230-241. PMID: 31954834. DOI: 10.1053/j.semtcvs.2020.01.001Toh H., Mori S., Tretter J.T., Izawa Y., Shimoyama S., Suzuki M., Takahashi Y., Tsuda D., Toba T., Fujiwara S., Hirata K., Anderson R.H.. Living Anatomy of the Ventricular Myocardial Crescents Supporting the Coronary Aortic Sinuses. Seminars in thoracic and cardiovascular surgery. 2020 Summer;32(2):230-241. PMID: 31954834. DOI: 10.1053/j.semtcvs.2020.01.001Yamada T, Lau YR, Litovsky SH, et al: Prevalence and clinical, electrocar- diographic, and electrophysiologic characteristics of ventricular arrhyth- mias originating from the noncoronary sinus of Valsalva. Heart Rhythm 10:1605–1612, 2013Yamada T, Lau YR, Litovsky SH, et al: Prevalence and clinical, electrocar- diographic, and electrophysiologic characteristics of ventricular arrhyth- mias originating from the noncoronary sinus of Valsalva. Heart Rhythm 10:1605–1612, 2013De Kerchove L., Jashari R., Boodhwani M., Duy K.T., Lengele B., Gianello P., Nezhad Z.M., Astarci P., Noirhomme P., El Khoury G.. Surgical anatomy of the aortic root: Implication for valve-sparing reimplantation and aortic valve annuloplasty. The Journal of thoracic and cardiovascular surgery. 2015 Feb;149(2):425-33. PMID: 25439782. DOI: 10.1016/j.jtcvs.2014.09.042De Kerchove L., Jashari R., Boodhwani M., Duy K.T., Lengele B., Gianello P., Nezhad Z.M., Astarci P., Noirhomme P., El Khoury G.. Surgical anatomy of the aortic root: Implication for valve-sparing reimplantation and aortic valve annuloplasty. The Journal of thoracic and cardiovascular surgery. 2015 Feb;149(2):425-33. PMID: 25439782. DOI: 10.1016/j.jtcvs.2014.09.042O’Connor S.A., Morice M.C., Gilard M., Leon M.B., Webb J.G., Dvir D., Rodés-Cabau J., Tamburino C., Capodanno D., D’Ascenzo F., Garot P., Chevalier B., Mikhail G.W., Ludman P.F.. Revisiting sex equality with transcatheter aortic valve replacement outcomes: a collaborative, patient-level meta-analysis of 11,310 patients. Journal of the American College of Cardiology. 2015 Jul 21;66(3):221-228. PMID: 26184614. DOI: 10.1016/j.jacc.2015.05.024.O’Connor S.A., Morice M.C., Gilard M., Leon M.B., Webb J.G., Dvir D., Rodés-Cabau J., Tamburino C., Capodanno D., D’Ascenzo F., Garot P., Chevalier B., Mikhail G.W., Ludman P.F.. Revisiting sex equality with transcatheter aortic valve replacement outcomes: a collaborative, patient-level meta-analysis of 11,310 patients. Journal of the American College of Cardiology. 2015 Jul 21;66(3):221-228. PMID: 26184614. DOI: 10.1016/j.jacc.2015.05.024.Du F., Liu X., Zhu Q., He Y., Jiang J., Napawan T., Jaiswal S., Chen Z., Wang J.. Sex-specific aortic root anatomy in patients with bicuspid aortic valve undergoing TAVR in a Chinese cohort. Herz. 2020 Jun;45(4):375-381. PMID: 30483815. DOI: 10.1007/s00059-018-4740-0Du F., Liu X., Zhu Q., He Y., Jiang J., Napawan T., Jaiswal S., Chen Z., Wang J.. Sex-specific aortic root anatomy in patients with bicuspid aortic valve undergoing TAVR in a Chinese cohort. Herz. 2020 Jun;45(4):375-381. PMID: 30483815. DOI: 10.1007/s00059-018-4740-0Contino M., Mangini A., Lemma M.G., Romagnoni C., Zerbi P., Gelpi G., Antona C.. A geometric approach to aortic root surgical anatomy. European journal of cardio-thoracic surgery. 2016 Jan;49(1):93-100. PMID: 25724903. DOI: 10.1093/ejcts/ezv059.Contino M., Mangini A., Lemma M.G., Romagnoni C., Zerbi P., Gelpi G., Antona C.. A geometric approach to aortic root surgical anatomy. European journal of cardio-thoracic surgery. 2016 Jan;49(1):93-100. PMID: 25724903. DOI: 10.1093/ejcts/ezv059.Mori S, Anderson RH, Tahara N, 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 Mar;34(3):453-461.doi: 10.1111/echo.13468. PMID: 28160343.Mori S, Anderson RH, Tahara N, 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 Mar;34(3):453-461.doi: 10.1111/echo.13468. PMID: 28160343.Federspiel J.M., Ehrlich T., Abeln K., Schäfers H-J.. Aortic annuloplasty: Subcomissural, intra-annular suture techniques, external and internal rings. JTCVS Techniques. 2021. Jun; 7: 98–102. PMID: 34318215. doi: 10.1016/j.xjtc.2020.12.044Federspiel J.M., Ehrlich T., Abeln K., Schäfers H-J.. Aortic annuloplasty: Subcomissural, intra-annular suture techniques, external and internal rings. JTCVS Techniques. 2021. Jun; 7: 98–102. PMID: 34318215. doi: 10.1016/j.xjtc.2020.12.044Youssefi P., Lansac E.. Aortic annulus and the importance of annuloplasty. Indian journal of thoracic and cardiovascular surgery. 2020 Jan;36(Suppl 1):88-96. PMID: 33061189. doi: 10.1007/s12055-019-00852-9Youssefi P., Lansac E.. Aortic annulus and the importance of annuloplasty. Indian journal of thoracic and cardiovascular surgery. 2020 Jan;36(Suppl 1):88-96. PMID: 33061189. doi: 10.1007/s12055-019-00852-9Izawa Y., Mori S., Tretter J.T., Quintessenza J.A., Toh H., Toba T., Watanabe Y., Kono A.K., Okada K., Hirata K-I.. Normative aortic valvar measurements in adults using cardiac computed tomography - a potential guide to further sophisticate aortic valve-sparing surgery. Circulation journal. 2021 Jun 25;85(7):1059-1067. PMID: 33408304. DOI: 10.1253/circj.CJ-20-0938.Izawa Y., Mori S., Tretter J.T., Quintessenza J.A., Toh H., Toba T., Watanabe Y., Kono A.K., Okada K., Hirata K-I.. Normative aortic valvar measurements in adults using cardiac computed tomography - a potential guide to further sophisticate aortic valve-sparing surgery. Circulation journal. 2021 Jun 25;85(7):1059-1067. PMID: 33408304. DOI: 10.1253/circj.CJ-20-0938.Randhawa A., Gupta T., Singh P., Aggarwal A., Sahni D.. Description of the aortic root anatomy in relation to transcatheter aortic valve implantation. Cardiovascular pathology. 2019 May-Jun;40:19-23. PMID: 30772639. DOI: 10.1016/j.carpath.2019.01.005Randhawa A., Gupta T., Singh P., Aggarwal A., Sahni D.. Description of the aortic root anatomy in relation to transcatheter aortic valve implantation. Cardiovascular pathology. 2019 May-Jun;40:19-23. PMID: 30772639. DOI: 10.1016/j.carpath.2019.01.005Kheradvar A., Vannan M.A., Lakshmi P.D., Pedrizzetti G.. The effect of aortic root anatomy vortex flow induced shear stress on the aortic valve leaflets. European heart journal. Cardiovascular Imaging. 2021 Aug 14;22(9):995-997. PMID: 33758910. DOI: 10.1093/ehjci/jeab031.Kheradvar A., Vannan M.A., Lakshmi P.D., Pedrizzetti G.. The effect of aortic root anatomy vortex flow induced shear stress on the aortic valve leaflets. European heart journal. Cardiovascular Imaging. 2021 Aug 14;22(9):995-997. PMID: 33758910. DOI: 10.1093/ehjci/jeab031.Nasr A.Y., Tahlawi M.E.. Anatomical and radiological angiographic study of the coronary ostia in the adult human hearts and their clinical significance. Anatomy & cell biology. 2018 Sep;51(3):164-173. PMID: 30310708. DOI: 10.5115/acb.2018.51.3.164.Nasr A.Y., Tahlawi M.E.. Anatomical and radiological angiographic study of the coronary ostia in the adult human hearts and their clinical significance. Anatomy & cell biology. 2018 Sep;51(3):164-173. PMID: 30310708. DOI: 10.5115/acb.2018.51.3.164.Agrawal R. Anatomical study of coronary ostia in cadaveric hu man heart. Global Journal For Research Analysis. 2018 Mar; 7(3): 23-25.Agrawal R. Anatomical study of coronary ostia in cadaveric hu man heart. Global Journal For Research Analysis. 2018 Mar; 7(3): 23-25.Smettei O.A., Sayed S., Abazid R.M.. The prevalence of coronary artery anomalies in Qassim Province detected by cardiac computed tomography angiography. Journal of the Saudi Heart Association. 2017 Apr;29(2):84-89. PMID: 28373781. DOI: 10.1016/j.jsha.2016.07.006.Smettei O.A., Sayed S., Abazid R.M.. The prevalence of coronary artery anomalies in Qassim Province detected by cardiac computed tomography angiography. Journal of the Saudi Heart Association. 2017 Apr;29(2):84-89. PMID: 28373781. DOI: 10.1016/j.jsha.2016.07.006.Villa A.D., Sammut E., Nair A., Rajani R., Bonamini R., Chiribiri A.. Coronary artery anomalies overview: the normal and the abnormal. World J Radiol. 2016;8:537–55.Villa A.D., Sammut E., Nair A., Rajani R., Bonamini R., Chiribiri A.. Coronary artery anomalies overview: the normal and the abnormal. World J Radiol. 2016;8:537–55.Fujiyoshi T., Matsumoto R., Kamiya K., Ogino H.. Inter‐operative determination of the aortic root and cusp geometry associated with the aortic regurgitation grade. Surgery today. 2021 Mar;51(3):384-390. PMID: 32776293Fujiyoshi T., Matsumoto R., Kamiya K., Ogino H.. Inter‐operative determination of the aortic root and cusp geometry associated with the aortic regurgitation grade. Surgery today. 2021 Mar;51(3):384-390. PMID: 32776293De Kerchove L., Momeni M., Aphram G., Watremez C., Bollen X., Jashari R., Boodhwani M., Astarci P., Noirhomme P., El Khoury G.. Free margin length and coaptation surface area in normal tricuspid aortic valve: an anatomical study. European journal of cardio-thoracic surgery. 2018 May 1;53(5):1040-1048. PMID: 29253123. DOI: 10.1093/ejcts/ezx456De Kerchove L., Momeni M., Aphram G., Watremez C., Bollen X., Jashari R., Boodhwani M., Astarci P., Noirhomme P., El Khoury G.. Free margin length and coaptation surface area in normal tricuspid aortic valve: an anatomical study. European journal of cardio-thoracic surgery. 2018 May 1;53(5):1040-1048. PMID: 29253123. DOI: 10.1093/ejcts/ezx456Komiya T., Shimamoto T., Nonaka M., Matsuo T.. Is small cusp size a limitation for aortic valve repair? European journal of cardio-thoracic surgery. 2019 Sep 1;56(3):497-502. PMID: 30824918. DOI: 10.1093/ejcts/ezz053.Komiya T., Shimamoto T., Nonaka M., Matsuo T.. Is small cusp size a limitation for aortic valve repair? European journal of cardio-thoracic surgery. 2019 Sep 1;56(3):497-502. PMID: 30824918. DOI: 10.1093/ejcts/ezz053.Khelil N., Sleilaty G., Palladino M., Fouda M., Escande R., Debauchez M., Di Centa I., Lansac E.. Surgical anatomy of the aortic annulus: landmarks for external annuloplasty in aortic valve repair. The Annals of thoracic surgery. 2015 Apr;99(4):1220-6. PMID: 25728963. DOI: 10.1016/j.athoracsur.2014.12.034.Khelil N., Sleilaty G., Palladino M., Fouda M., Escande R., Debauchez M., Di Centa I., Lansac E.. Surgical anatomy of the aortic annulus: landmarks for external annuloplasty in aortic valve repair. The Annals of thoracic surgery. 2015 Apr;99(4):1220-6. PMID: 25728963. DOI: 10.1016/j.athoracsur.2014.12.034.Schäfers Р-J., Schmied W., Marom G., Aicher D.. Cusp height in aortic valves. The Journal of thoracic and cardiovascular surgery. 2013 Aug;146(2):269-74. PMID: 22853942. DOI: 10.1016/j.jtcvs.2012.06.053.Schäfers Р-J., Schmied W., Marom G., Aicher D.. Cusp height in aortic valves. The Journal of thoracic and cardiovascular surgery. 2013 Aug;146(2):269-74. PMID: 22853942. DOI: 10.1016/j.jtcvs.2012.06.053.Yang T., Wen H., El-Hamamsy I., Ni Q., Sun Y., Zhu D.. Relationship between leaflets and root in normal aortic valve based on computed tomography imaging: implication for aortic valve repair. Frontiers in cardiovascular medicine. 2021 Nov 22;8:731440. PMID: 34881298. DOI: 10.3389/fcvm.2021.731440.Yang T., Wen H., El-Hamamsy I., Ni Q., Sun Y., Zhu D.. Relationship between leaflets and root in normal aortic valve based on computed tomography imaging: implication for aortic valve repair. Frontiers in cardiovascular medicine. 2021 Nov 22;8:731440. PMID: 34881298. DOI: 10.3389/fcvm.2021.731440.Abeln K.B., Giebels C., Ehrlich T., Federspiel J.M., Schäfers H-J.. Which Aortic Valve Can Be Surgically Reconstructed? Current cardiology reports. 2021 Jul 2;23(8):108. PMID: 34213661. DOI: 10.1007/s11886-021-01525-z.Abeln K.B., Giebels C., Ehrlich T., Federspiel J.M., Schäfers H-J.. Which Aortic Valve Can Be Surgically Reconstructed? Current cardiology reports. 2021 Jul 2;23(8):108. PMID: 34213661. DOI: 10.1007/s11886-021-01525-z.Chirichilli I., Irace F., Weltert L., Tsuda K., Scaffa R., Salica A., Galea N., De Paulis R.. Morphological modification of the aortic annulus in tricuspid and bicuspid valves after valve reimplantation: an electrocardiography-gated computed tomography study. European journal of cardio-thoracic surgery. 2019 Oct 1;56(4):778-784. PMID: 30859210. DOI: 10.1093/ejcts/ezz065.Chirichilli I., Irace F., Weltert L., Tsuda K., Scaffa R., Salica A., Galea N., De Paulis R.. Morphological modification of the aortic annulus in tricuspid and bicuspid valves after valve reimplantation: an electrocardiography-gated computed tomography study. European journal of cardio-thoracic surgery. 2019 Oct 1;56(4):778-784. PMID: 30859210. DOI: 10.1093/ejcts/ezz065.Kong W.K.F., Regeer M.V., Poh K.K., Yip J.W., van Rosendael P.J., Yeo T.C., Tay E., Kamperidis V., van der Velde E.T., Mertens B., Marsan N.A., Delgado V., Bax J.J..Inter-ethnic differences in valve morphology, valvular dysfunction, and aortipathy between Asian and European patients with bicuspid aortic valve. European heart journal. 2018 Apr 14;39(15):1308-1313. PMID: 29029058. DOI: 10.1093/eurheartj/ehx562Kong W.K.F., Regeer M.V., Poh K.K., Yip J.W., van Rosendael P.J., Yeo T.C., Tay E., Kamperidis V., van der Velde E.T., Mertens B., Marsan N.A., Delgado V., Bax J.J..Inter-ethnic differences in valve morphology, valvular dysfunction, and aortipathy between Asian and European patients with bicuspid aortic valve. European heart journal. 2018 Apr 14;39(15):1308-1313. PMID: 29029058. DOI: 10.1093/eurheartj/ehx562Rodríguez-Palomares J.F., Dux-Santoy L., Guala A., Kale R., Maldonado G., Teixidó-Turà G., Galian L., Huguet M., Valente F., Gutiérrez L., González-Alujas T., Johnson M.K., Wieben O., García-Dorado D., Evangelista A.. Journal of cardiothoracic magnetic resonance. 2018 Apr 26;20(1):28. PMID: 29695249. DOI: 10.1186/s12968-018-0451-1.Rodríguez-Palomares J.F., Dux-Santoy L., Guala A., Kale R., Maldonado G., Teixidó-Turà G., Galian L., Huguet M., Valente F., Gutiérrez L., González-Alujas T., Johnson M.K., Wieben O., García-Dorado D., Evangelista A.. Journal of cardiothoracic magnetic resonance. 2018 Apr 26;20(1):28. PMID: 29695249. DOI: 10.1186/s12968-018-0451-1.Komarov R.N., Noginov V.K. The possibilities of valve-sparing surgical treatment of bicuspid aortic valve syndrome. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2022;26(2):9-16. (In Russ.) https://dx.doi.org/10.21688/1681-3472-2022-2-9-16.Komarov R.N., Noginov V.K. The possibilities of valve-sparing surgical treatment of bicuspid aortic valve syndrome. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2022;26(2):9-16. (In Russ.) https://dx.doi.org/10.21688/1681-3472-2022-2-9-16.Mahadevia R., Barker A.J., Schnell S., Entezari P., Kansal P., Fedak P.W., Malaisrie S.C., McCarthy P., Collins J., Carr J., Markl M.. Bicuspid aortic cusp fusion morphology alters aortic three-dimensional outflow patterns, wall shear stress, and expression of aortopathy. Circulation 2014 Feb 11;129(6):673-82. PMID: 24345403. DOI: 10.1161/CIRCULATIONAHA.113.003026.Mahadevia R., Barker A.J., Schnell S., Entezari P., Kansal P., Fedak P.W., Malaisrie S.C., McCarthy P., Collins J., Carr J., Markl M.. Bicuspid aortic cusp fusion morphology alters aortic three-dimensional outflow patterns, wall shear stress, and expression of aortopathy. Circulation 2014 Feb 11;129(6):673-82. PMID: 24345403. DOI: 10.1161/CIRCULATIONAHA.113.003026.Della Corte A., Bancone C., Dialetto G., Covino F.E., Manduca S., Montibello M.V., De Feo M., Buonocore M., Nappi G.. The ascending aorta with bicuspid aortic valve: a phenotypic classification with potential prognostic significance. European journal of cardio-thoracic surgery. 2014 Aug;46(2):240-7. PMID: 24431175. DOI: 10.1093/ejcts/ezt621Della Corte A., Bancone C., Dialetto G., Covino F.E., Manduca S., Montibello M.V., De Feo M., Buonocore M., Nappi G.. The ascending aorta with bicuspid aortic valve: a phenotypic classification with potential prognostic significance. European journal of cardio-thoracic surgery. 2014 Aug;46(2):240-7. PMID: 24431175. DOI: 10.1093/ejcts/ezt621Shaefer B.M., Lewin M.B., Stout K.K., Gill E., Prueitt A., Byers P.H., Otto C.M.. The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape. Heart. 2008 Dec;94(12):1634-8. PMID: 18308868. DOI: 10.1136/hrt.2007.132092.Shaefer B.M., Lewin M.B., Stout K.K., Gill E., Prueitt A., Byers P.H., Otto C.M.. The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape. Heart. 2008 Dec;94(12):1634-8. PMID: 18308868. DOI: 10.1136/hrt.2007.132092.Park C.B., Greason K.L., Suri R.M., Michelena H.I., Schaff H.V., Sundt 3rd T.M.. Fate of nonreplaced sinuses of Valsalva in bicuspid aortic valve disease. The journal of thoracic and cardiovascular surgery. 2011 Aug;142(2):278-84. PMID: 21036368. DOI: 10.1016/j.jtcvs.2010.08.055.Park C.B., Greason K.L., Suri R.M., Michelena H.I., Schaff H.V., Sundt 3rd T.M.. Fate of nonreplaced sinuses of Valsalva in bicuspid aortic valve disease. The journal of thoracic and cardiovascular surgery. 2011 Aug;142(2):278-84. PMID: 21036368. DOI: 10.1016/j.jtcvs.2010.08.055.Fazel S.S., Mallidi H.R., Lee R.S., Sheehan M.P., Liang D., Fleischman D., Herfkens R., Mitchell R.S., Miller D.C.. The aortopathy of bicuspid aortic valve disease has distinctive patterns and usually involves the transverse aortic arch. The journal of thoracic and cardiovascular surgery. 2008 Apr;135(4):901-7, 907.e1-2. PMID: 18374778. DOI: 10.1016/j.jtcvs.2008.01.022.Fazel S.S., Mallidi H.R., Lee R.S., Sheehan M.P., Liang D., Fleischman D., Herfkens R., Mitchell R.S., Miller D.C.. The aortopathy of bicuspid aortic valve disease has distinctive patterns and usually involves the transverse aortic arch. The journal of thoracic and cardiovascular surgery. 2008 Apr;135(4):901-7, 907.e1-2. PMID: 18374778. DOI: 10.1016/j.jtcvs.2008.01.022.Kim D.H., Handschumacher M.D., Levine R.A., et al. Aortic valve adaptation to aortic root dilatation: insights into the mechanism of functional aortic regurgitation from 3-dimensional cardiac computed tomography. Circ Cardiovasc Imaging. 2014;7(5):828–835Kim D.H., Handschumacher M.D., Levine R.A., et al. Aortic valve adaptation to aortic root dilatation: insights into the mechanism of functional aortic regurgitation from 3-dimensional cardiac computed tomography. Circ Cardiovasc Imaging. 2014;7(5):828–835Ballocca F., Ruggeri G.M., Roscoe A., Thampinathan B., David T.E., Lang R.M., Meineri M., Tsang W.. Aortic root changes before and after surgery for chronic aortic dilatation: A 3D Echocardiographic study. Echocardiography. 2019 Feb;36(2):376-385. PMID: 30556230. DOI: 10.1111/echo.14216Ballocca F., Ruggeri G.M., Roscoe A., Thampinathan B., David T.E., Lang R.M., Meineri M., Tsang W.. Aortic root changes before and after surgery for chronic aortic dilatation: A 3D Echocardiographic study. Echocardiography. 2019 Feb;36(2):376-385. PMID: 30556230. DOI: 10.1111/echo.14216Ju M.H., Oh S.Y., Choo S.J., Yang D.H., Kang J-W., Kim J.B., Shinn S.H., Lee J.W., Lim T-H.. Three-Dimensional Computed Tomographic Analysis of Normal and Aneurysmal Aortic Roots: Is There a Specific Geometric Pattern in the Aortic Root? Clinical Anatomy. 2020 Jan;33(1):117-123. PMID: 31576608. DOI: 10.1002/ca.23482.Ju M.H., Oh S.Y., Choo S.J., Yang D.H., Kang J-W., Kim J.B., Shinn S.H., Lee J.W., Lim T-H.. Three-Dimensional Computed Tomographic Analysis of Normal and Aneurysmal Aortic Roots: Is There a Specific Geometric Pattern in the Aortic Root? Clinical Anatomy. 2020 Jan;33(1):117-123. PMID: 31576608. DOI: 10.1002/ca.23482.David T. E.. Additional anatomic information on the aortic root. The Journal of thoracic and cardiovascular surgery. 2015 Feb;149(2):408-10. PMID: 25457257. DOI: 10.1016/j.jtcvs.2014.10.014.David T. E.. Additional anatomic information on the aortic root. The Journal of thoracic and cardiovascular surgery. 2015 Feb;149(2):408-10. PMID: 25457257. DOI: 10.1016/j.jtcvs.2014.10.014.Sasaki K., Kunihara T., Kasegawa H., Seki M., Seki H., Takada J., Sasuga S., Kumazawa R., Umezu M., Iwasaki K.. Aortic root geometry following valve‐sparing root replacement with reimplantation or remodeling: experimental investigation under static continuous pressure. Journal of artificial organs. 2021 Jun;24(2):245-253. PMID: 33484362. DOI: 10.1007/s10047-020-01242-4Sasaki K., Kunihara T., Kasegawa H., Seki M., Seki H., Takada J., Sasuga S., Kumazawa R., Umezu M., Iwasaki K.. Aortic root geometry following valve‐sparing root replacement with reimplantation or remodeling: experimental investigation under static continuous pressure. Journal of artificial organs. 2021 Jun;24(2):245-253. PMID: 33484362. DOI: 10.1007/s10047-020-01242-4

The authors declare that there are no conflicts of interest present.