OBJECTIVE
To assessment blood flow and wall shear stress in the left ventricle and aorta in ascending aortic aneurysms with aortic insufficiency before and after surgery.
MATERIAL AND METHODS
78 patients with ascending and root aortic aneurysm and aortic valve insufficiency were examined. The age of the patients was 52.85±14.5 years. There were 61 (78.2%) men and 17 (21.8%) women in the study. All patients in conditions of artificial circulation underwent surgical treatment according to the methods of T. David, El-Khoury, Bentall-DeBono. Transthoracic echocardiography and MSCT before and after surgery were performed according to the protocol. The results were processed in the Multivox and Ansis software. Echocardiography was performed on devices of the expert class VIVID-E9, VIVID-E95 (GE HC, USA) with a 3.5-4.6 MHz multi-frequency matrix sensor. The aortic walls were they divided into 4 sections to record the displacement rates and shear length of the vascular wall. The linear dimensions of the aorta, the rate of blood flow in the aorta and left ventricle, and the shear stress of the wall were calculated.
RESULTS
Prior to surgery, patients had an increase in the blood flow rate on the aortic valve. In the ascending aorta, there was an increase in the displacement of all segments of the aortic walls with a change in the stereometry of the root. There is a statistically significant (p<0.01) increase in the rate of displacement of segments of the aortic wall with an increase in flow rates in the outflow tract of the left ventricle to 29±9 cm/s and above the aortic valve to 19±8 cm/s. After prosthetics of the ascending aorta, the displacement rates of the aortic walls decrease (p<0.001) from 6.5 mm/s to 2.6 mm/s. The direction of blood flow becomes uniform with a decrease in turbulence in the left ventricle and aorta.
CONCLUSION
The dynamics of changes in blood flows and quantitative assessment by vector mapping of the aortic walls is one of the characteristics of the results of surgical treatment. A decrease in the shear parameters and displacement rates of the aortic segments after surgery indicates the restoration of dynamic equilibrium between the aorta and the left ventricle.
