The shortage of organs for transplant remains a major challenge in transplantology. Transporting donor organs over long distances increases cold ischemia time, which is a risk factor for ischemia-reperfusion injury (IRI). In the face of critical shortages, the method and timing of organ preservation are crucial in increasing the donor pool. This paper examines the approaches, benefits, and drawbacks of organ preservation techniques used around the world.

Objective: to conduct a comparative study of the efficacy of Custodiol® cardioplegia (Custodiol HTK, Dr. Franz Köhler Chemie GmbH, Bensheim, Germany) and normothermic autoperfusion of heart graft as a part of an ex vivo cardiopulmonary complex (CPC). Methods. Landrace pigs weighing 50 ± 5 kg and aged 4–5 months (n = 10) were used as the model for a series of acute experiments. In the experimental group (n = 5), the CPC was conditioned by autoperfusion for 6 hours. In the control group, the heart’s pumping function was restored after a 6-hour cold preservation with Custodiol®. The effectiveness of cardiac graft preservation methods was evaluated by measuring myocardial ischemic markers, endothelial synthetic function, and endothelial cell activation markers (E- and P-selectins, endothelial growth factor).Results. Following cardiac graft reperfusion, the control group exhibited a statistically significant increase in the concentration of myocardial ischemia markers; also, there was a significant decrease in the synthesis of endothelium-derived relaxing factor in the Custodiol® solution preservation group (378.5 [226.4; 539.7] vs. 542.1 [377.6; 853.2] μM/mL in the autoperfusion group, p < 0.05). The degree of coronary endothelial reperfusion injury/activation was several times higher in the control group than in the normothermic autoperfusion conditioning group. Moreover, cardiac output after a 6-hour graft conditioning was 0.63 [0.37; 0.80] and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (p < 0.05).Conclusion. Normothermic autoperfusion showed a significant advantage in preserving the morphofunctional status of the donor heart compared with cold preservation with Custodiol® during 6 hours of ex vivo graft conditioning.

Цель. Проанализировать взаимосвязи картины магнитно-резонансной томографии (МРТ) сердца и органов грудной клетки с парамагнитным контрастным усилением и постковидных наджелудочковых нарушений ритма сердца, у пациентов после перенесенной ковид-ассоциированной пневмонии.

Цель. Провести сравнительный анализ эффективности использования различных методов лучевой диагностики (эхокардиография (ЭхоКГ), компьютерно-томографическая ангиография (КТА), магнитно-резонансная томография (МРТ)) в оценке особенностей корня аорты у пациентов с выраженным аортальным стенозом для улучшения процессов биотехнического проектирования при разработке новых моделей искусственного аортального клапана (АК).

Objective : to develop and approve the surgical technique for explantation of a functioning cardiopulmonary complex under normothermic autoperfusion. Materials and methods . Landrace pigs were used as the experimental model for a series of acute experiments (n = 10). During the experiment, invasive pressure in the cavities of the heart and main arteries, blood gas composition, and myocardial contractility were monitored. The functioning cardiopulmonary complex was explanted through a median sternotomy. The explanted complex was conditioned at 37–38 °C for 6 hours. Results . In the course of a series of experiments, it was shown that stable operation of the isolated heart-lung complex ex vivo for 6 hours was fundamentally possible provided that the parameters of the basic homeostasis constants are maintained. The technological solutions used made it possible to ensure safe hemodynamic and anatomical isolation of the working cardiopulmonary complex. Conclusion . The developed protocol for isolating a functioning cardiopulmonary complex allows to provide stable graft function for 6 hours under normothermic autoperfusion. Implementation of this concept in the development of transport systems would significantly facilitate their design and eliminate the use of expensive components. This would contribute to widespread introduction into clinical practice.

Background. Chest MRI allows diagnosing in the acute period of covid-associated pneumonia (CAP) and assessing the dynamics of treatment. The potential of MRI in postcovid pulmonary arterial hypertension (PAH) study remains unclear. Objective. To examine the chest MRI picture in CAP patients and to quantify the signs of post-COVID PAH. Design and methods. The study included 34 patients who underwent COVID-19 within 3.5–7 months with involvement of the parenchyma of mild severity upon admission of CT1–CT3 according to spiral X-ray CT. All patients underwent chest MRI in ECG- and respiratory-synchronized T1- (T1-WI), T2 (T2-WI) and diffusion-weighted MRI protocols and ultrasound of the heart and large vessels of the chest cavity, with the calculation of systolic pressure in the right ventricle (SPRV). Results. Three groups were distinguished: CT1 (group 1), CT2 (group 2) and CT3 (group 3). The frequency of subsegmental/segmental signs of LA branches thromboembolism was significantly higher in groups CT2 and CT3. LA diameter, SPRV and T1-WI intensity ratio index {Lung/LA} progressively increased from group 1 to group 3. The dependence of SPRV on the {Lung/LA} was fitted using Boltzmann curve (r = 0.92, p < 0.01). Conclusion. Chest MRI in T1- WI allows assessing the degree of post-covid changes in the lung parenchyma thickness and predicting early forms of increased pulmonary arterial pressure and the formation of PAH.

Objective: To compare the effectiveness of 6-hour normothermic autoperfusion of a heart graft ex vivo with pharmaco-cold preservation using Bretschneider's solution (Custodiol, Dr Franz Köhler Chemie GmbH, Bensheim, Germany).Methods: Landrace pigs weighing 50 ± 5 kg and aged 4–5 months (n = 10) were selected as a model for a series of acute experiments. Cardiopulmonary conditioning using autoperfusion was conducted for 6 hours on the experimental group (n = 5). On the other hand, the control group underwent a 6-hour pharmaco-cold preservation with Bretschneider solution to recover the heart's pumping function. Graft preservation effectiveness was evaluated by measuring hemodynamic parameters, heartbeat, and myocardial ischemia marker concentrations.Results: After reperfusion and isolation of the working cardiopulmonary complex, cardiac output was 0.63 [0.37; 0.8] L/min and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (P < .05). The levels of CPK-MB, LDH, troponin-I, and lactate in the coronary sinus blood was significantly higher in the control group.Conclusion: The study demonstrated significant benefits of normothermic autoperfusion in maintaining the morphofunctional status of the donor heart compared to pharmaco-cold preservation using Bretschneider's solution for 6 hours of ex vivo graft conditioning. Received 16 July 2023. Revised 8 September 2023. Accepted 11 September 2023. Funding: The study was carried out within the framework of project No. 23-25-10013 (agreement No. 23-25-10013 dated April 20, 2023 with the Russian Science Foundation, agreement No. р-52 dated April 3, 2023 with the Ministry of Science and Innovation Policy of the Novosibirsk Region). Conflict of interest: The authors declare no conflict of interest. Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, I.S. ZykovData collection and analysis: M.O. Zhulkov, A.R. Tarkova, I.S. Zykov, A.G. Makaev, A.V. Protopopov, M.N. Murtazaliev, F.Yu. Kosimov, N.A. Karmadonova, Ya.M. Smirnov, E.E. Kliver, A.M. Volkov, H.A. Agaeva, D.A. SirotaStatistical analysis: M.O. ZhulkovDrafting the article: M.O. ZhulkovCritical revision of the article: M.O. Zhulkov, D.A. Sirota, I.S. ZykovFinal approval of the version to be published: M.O. Zhulkov, A.R. Tarkova, I.S. Zykov, A.G. Makaev, A.V. Protopopov, M.N. Murtazaliev, F.Yu. Kosimov, N.A. Karmadonova, Ya.M. Smirnov, E.E. Kliver, A.M. Volkov, H.A. Agaeva, D.A. Sirota

Цель. Провести сравнительное исследование эффективности 6-часовой нормотермической аутоперфузии сердечного трансплантата ex vivo и фармакохолодовой консервации кустодиолом (Custodiol HTK, Dr Franz Köhler Chemie GmbH, Бенсхайм, Германия). Методы. В качестве модели для проведения серии острых экспериментов использовали свиней породы ландрас весом 50 ± 5 кг в возрасте 4–5 мес. (n = 10). В экспериментальной группе (n = 5) кондиционирование сердечно-легочного комплекса проводили методом аутоперфузии в течение 6 ч. В контрольной группе восстановление насосной функции сердца осуществляли после 6-часовой фармакохолодовой консервации кустодиолом. Оценивали эффективность консервации трансплантата путем измерения параметров гемодинамики, ударной работы сердца, концентрации маркеров ишемии миокарда. Результаты. После реперфузии и изоляции работающего сердечно-легочного комплекса сердечный выброс составил 0,63 [0,37; 0,80] и 0,37 [0,23; 0,37] л/мин в экспериментальной и контрольной группах соответственно (р < 0,05). Концентрация креатинфосфокиназы-МВ, лактатдегидрогеназы, тропонина I и лактата в оттекающей из коронарного синуса крови была в 2 раза выше в группе контроля. Заключение. Нормотермическая аутоперфузия показала значительное преимущество в сохранении морфофункционального статуса донорского сердца по сравнению с фармакохолодовой консервацией кустодиолом в течение 6 ч кондиционирования трансплантата ex vivo. Поступила в редакцию 16 июля 2023 г. Исправлена 8 сентября 2023 г. Принята к печати 11 сентября 2023 г. Финансирование Исследование выполнено в рамках проекта № 23-25-10013 (соглашение № 23-25-10013 от 20.04.2023 г. с Российским научным фондом, соглашение № р-52 от 03.04.2023 г. с Министерством науки и инновационной политики Новосибирской области). Конфликт интересов Авторы заявляют об отсутствии конфликта интересов. Вклад авторов Концепция и дизайн работы: М.О. Жульков, Д.А. Сирота, И.С. Зыков Сбор и анализ данных: все авторы Статистическая обработка данных: М.О. Жульков Написание статьи: М.О. Жульков Исправление статьи: М.О. Жульков, Д.А. Сирота, И.С. Зыков Утверждение окончательного варианта статьи: все авторы

Objective: to carry out a comparative study of the efficacy of a 6-hour normothermic ex vivo heart and lung autoperfusion and cold cardioplegia using Bretschneider’s solution (Custodiol ® , Germany). Materials and methods. Landrace pigs weighing 50 ± 5 kg at the age of 4–5 months (n = 10) were used as a model for a series of acute experiments. In the experimental group (n = 5), the cardiopulmonary complex was conditioned by autoperfusion for 6 hours. In the control group, the heart pumping function was restored after 6-hour cold cardioplegia using Bretschneider’s solution. The efficiency of graft preservation was assessed by measuring hemodynamic parameters, myocardial contractile function, and myocardial oxygen consumption. Results. After reperfusion and repeated isolation of the working cardiopulmonary complex, cardiac output was 0.63 [0.37; 0.8] L/min and 0.37 [0.23; 0.37] L/min in the experimental and control groups, respectively (p < 0.05). Indicators – global left ventricular stroke work index and preload recruitable stroke work – were significantly higher in the experimental group (p < 0.05). Conclusion. Normothermic autoperfusion is significantly more effective in preserving the morphofunctional status of a donor heart than static cold storage with Bretschneider solution for 6 hours.

In routine clinical practice, methods of radiation diagnostics are widely used in the provision of medical care to patients with common diseases of the brachiocephalic vessels (BCV). This article provides recommendations on methods for performing time-consuming and expensive radiological methods (ultrasound (US), computed tomography (CT), computed tomography angiography (CTA) arteries, CTA veins, magnetic resonance imaging (MRI)) in patients with diseases of the brachiocephalic vessels. Based on the recommendations of experts, literature sources and practical experience in the application of radiology methods. This guide contains structured information regarding the technology of US, CTA and MRI in patients with artery stenosis, artery dissection, vascular malformation, venous sinus thrombosis, and atherosclerosis. These recommendations are universal and are suitable for most medical institutions that perform US, CT and MRI of brachiocephalic vessels. Compliance with these rules will improve clinical and economic efficiency in the diagnosis, treatment and rehabilitation of patients with diseases of the brachiocephalic vessels by standardizing procedures of US, CT, MRI, and effectively use the resources of a Healthcare at all levels when performing radiological methods. The manual is intended for all categories of medical stuff performing radiological methods in diseases of brachiocephalic vessels (US doctors, functional diagnostics doctors, radiologists) and using their results in clinical practice (cardiologists, cardiovascular surgeons, neurologists, neurosurgeons, anesthesiologists, therapists).

Цель. Оценить влияние внутрикоронарного введения иопромида (Ultravist®, Bayer AG, Леверкузен, Германия) в период реализации фармакохолодовой консервации донорского сердца ex vivo на восстановление насосной функции сердца и метаболизм кардиомиоцитов в раннем посттрансплантационном периоде. Методы. В качестве экспериментальной модели использовали телят черно-пестрой породы в возрасте 3 мес. В контрольной группе фармакохолодовую консервацию донорского сердца выполняли введением в корень аорты 2 л раствора кустодиола (Custodiol®, Dr. Franz Köhler Chemie GmbH, Бенсхайм, Германия). Затем сердца хранили в соответствующем растворе при температуре от 0 до 1 °C в течение 2 ч. Спустя 120 мин консервации в экспериментальной группе (n = 6) в корень аорты вводили раствор иопромида (Ultravist®) и кустодиола в соотношении 50:50 в течение 5 мин под давлением 70–80 мм рт. ст., после чего отмывали коронарное русло 1 л раствора кустодиола под давлением 40 мм рт. ст. и выполняли ортотопическую трансплантацию сердца реципиенту. В посттрансплантационном периоде исследовали параметры центральной гемодинамики, потребления миокардом кислорода, уровень маркеров ишемии миокарда (тропонина-I, креатинфосфокиназы-МВ, лактатдегидрогеназы). Результаты. В ходе исследования выполнили 12 ортотопических трансплантаций сердца. Через 120 мин после восстановления самостоятельной сердечной деятельности уровень сердечного выброса составил 5,11 [4,99; 5,41] и 5,77 [4,97; 6,62] л/мин (р = 0,0009) в контрольной и экспериментальной группах соответственно. Изменения концентрации лактатдегидрогеназы, тропонина-I и лактата в оттекающей из коронарного синуса крови были значительно более выраженными в раннем реперфузионном периоде, однако статистически значимого различия между группами не выявили (р > 0,05). Потребление миокардом кислорода было значительно снижено на этапе реперфузии, однако к 60-й минуте реперфузии возвращалось к исходным значениям без достоверной разницы между группами (р > 0,05). Заключение. В ходе эксперимента доказана безопасность внутрикоронарного введения иопромида на этапе фармакохолодовой консервации донорского сердца ex vivo. Внутрикоронарное введение раствора иопромида не влияет на восстановление насосной функции сердца и метаболизма кардиомиоцитов в раннем посттрансплантационном периоде. Поступила в редакцию 6 мая 2022 г. Исправлена 14 июня 2022 г. Принята к печати 11 июля 2022 г. Финансирование Исследование не имело спонсорской поддержки. Конфликт интересов Авторы заявляют об отсутствии конфликта интересов. Вклад авторов Концепция и дизайн работы: М.О. Жульков, Д.А. Сирота, И.С. Зыков Сбор и анализ данных: М.О. Жульков, И.С. Зыков, А.К. Сабетов, Х.А. Агаева, А.Г. Макаев, Д.М. Осинцев, А.Э. Календарев, А.П. Надеев, В.Е. Кливер, А.Р. Таркова, М.А. Овчинникова, Н.А. Кармадонова, Д.В. Хомушку Статистическая обработка данных: М.О. Жульков, А.Г. Макаев Написание статьи: М.О. Жульков Исправление статьи: М.О. Жульков, Д.А. Сирота, И.С. Зыков, А.В. Фомичев Утверждение окончательного варианта статьи: все авторы

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<0.95. Type 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 of the aortic root, 1 patient had a type B, and 8 patients had a type C.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.

Objective: to evaluate the technical feasibility as well as functional, metabolic and structural integrity of donor heart myocardium after 4 hours of direct intracoronary oxygen persufflation in an experiment. Materials and methods. Mini-pig siblings aged 3 months with a body weight of 23–36 kg were used as the experimental model. In the control group (n = 8), donor hearts were cold preserved by injecting 2 liters of Bretschneider cardioplegic solution (Custodiol®, Germany, HTK) into the aortic root. In the experimental group (n = 8), modified HTK solution (with 40 mg/L hyaluronidase added) was used to initiate cardioplegia, then moistened carbogen (95% O2, 5% CO2) was injected into the ascending aorta, maintaining 40–45 mm Hg aortic root pressure. The hearts were stored in an mHTK solution at 0–4 °С. After 3 hours of donor heart preservation, orthotopic heart transplantation (OHTx) was performed. In the post-transplant period, we studied central hemodynamic parameters, myocardial oxygen consumption, level of myocardial ischemia markers (troponin I, TnI; creatine phosphokinase-MB, CPKMB; lactate dehydrogenase, LDH), and histological signs of structural cellular injury. Results. Sixteen OHTx surgeries were performed during the study. At 120 minutes after restoration of spontaneous cardiac activity, cardiac output was 2.99 [4.85; 3.17] L/min and 2.48 [2.04; 2.92] L/min (p > 0.05) in the control and experimental groups, respectively. Changes in LDH, TnI and lactate levels in the blood flowing from the coronary sinus were significantly higher in the early reperfusion period. However, there was no statistically significant difference between the groups (p > 0.05). Myocardial oxygen consumption in the control and experimental groups was 8.2 [7.35; 9.35] ml-O2/min/100 g and 7.7 [6.75; 10.12] ml-O2/min/100 g, respectively (p > 0.05). Morphological examinations also showed no significant myocardial ischemia injury in the persufflation group compared to the control group. Conclusion. The experiment showed the technical feasibility and safety of direct intracoronary oxygen persufflation for 4 hours at the ex vivo donor heart conditioning stage. At the same time, experimental data showed no significant advantages of coronary persufflation over the standard protocol of cold preservation of donor heart with Bretschneider cardioplegic solution.

Background. In recent years, transcatheter implantation of the aortic valve has become increasingly performed as an alternative to "open" prosthetics. The undoubted advantage of this technology is its minimally invasive nature, which in most cases provides a favorable clinical outcome of the intervention. The transcatheter method of aortic valve prosthetics does not require sternotomy and connection of an artificial circulation device, which significantly reduces the risk of postoperative mortality and complications. However, despite all the advantages of the existing models, they are not without drawbacks that force researchers to develop and test new transcatheter valves. The problem of experimental studies of new models of self-opening transcatheter aortic valves is mainly determined by the anatomical features of the aortic root of animals. In this regard, the development of a reliable method of implantation of valve prostheses in the experiment is an urgent problem of preclinical testing.Aim. Development of a protocol for open implantation of a transcatheter aortic valve in experiment and evaluation of long-term results.Methods. To develop an experimental model, pigs of the "Landras" breed, females weighing 129.83 ± 9 kg were used. Transcatheter aortic valve implantation was performed under conditions of artificial circulation and moderate hypothermia (33-34°C) through a transverse aortotomy under the control of vision. During the experiment, invasive monitoring of blood pressure, central venous pressure, heart rhythm, body temperature, blood gas composition, activated clotting time was performed. The correct positioning and hemodynamic parameters after implantation were evaluated using transesophageal echocardiography.Results. In a series of chronic experiments, 18 open implantations of self-opening transcatheter aortic valves were performed. Successful positioning was achieved in 100% of cases. The developed protocol of open implantation made it possible to achieve reliable fixation of the prosthesis in the orthotopic position, as well as to prevent the migration of the prosthesis, the development of mitral regurgitation, paraaortic fistulas and coronary circulation disorders.Conclusion. In the course of the study, a simple and effective method of open implantation of a transcatheter aortic heart valve prosthesis was developed in an experiment. Received 1 October 2021. Revised 1 November 2021. Accepted 12 November 2021. Funding: This work was carried out within the framework of the state task of Ministry of Health of Russian Federation No. 121032300337-5. Conflict of interest: Authors declare no conflict of interest. Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, K.V. Kozyr, D.S. SergeevichevData collection and analysis: M.O. ZhulkovDrafting the article: M.O. ZhulkovCritical revision of the article: D.A. Sirota, A.M. ChernyavskiyExperimental part: M.O. Zhulkov, H.A. Agaeva, A.K. Sabetov, I.S. Zykov, A.R. TarkovaFinal approval of the version to be published: M.O. Zhulkov, K.V. Kozyr, I.S. Zykov, A.R. Tarkova, H.A. Agaeva, A.K. Sabetov, D.A. Sirota, D.S. Sergeevichev, A.M. Chernyavski

Objective: To evaluate the effect of intracoronary iopromide (Ultravist®, Bayer, AG, Leverkusen, Germany) during pharmaco-cold ex vivo preservation of a donor heart on the restoration of heart pumping function and cardiomyocyte metabolism in the early post-transplant period.Methods: Black-and-white calves aged 3 months were used as an experimental model. In the control group, pharmaco-cold preservation of the donor heart was performed by injecting 2 liters of custodiol (Custodiol®, Dr. Franz Köhler Chemie GmbH, Bensheim, Germany) into the aortic root. The hearts were then stored in an appropriate solution at 0 to 1°C for 2 hours. In the experimental group (n = 6), a solution of iopromide and custodiol were injected into the aortic root at a ratio of 50:50 under a pressure of 70-80 mm Hg for 5 minutes after 120 minutes of preservation. Then the coronary bed was washed with 1 liter of custodiol at a pressure of 40 mm Hg and orthotopic heart transplantation was performed. In the post-transplant period, the parameters of central hemodynamics, myocardial oxygen consumption, and the levels of myocardial ischemia markers (troponin I, creatine phosphokinase-MB, lactate dehydrogenase) were assessed.Results: Twelve orthotopic heart transplantations were performed during the study. In 120 minutes after the restoration of spontaneous cardiac activity, the level of cardiac output was 5.11 [4.99; 5.41] L/min and 5.77 [4.97; 6.62] L/min (p = 0.0009) in the control and experimental groups, respectively. Changes in the concentration of lactate dehydrogenase, troponin I and lactate in the blood flowing from the coronary sinus were significantly higher in the early reperfusion period. However, no statistically significant difference was observed between the groups (p > 0.05). Myocardial oxygen consumption was significantly reduced at reperfusion. However, the initial values were restored by reperfusion minute 60 without any significant intergroup difference (p > 0.05).Conclusion: We established the safety of intracoronary iopromide administration for pharmaco-cold ex vivo preservation of the donor heart. Intracoronary administration of iopromide solution does not affect the restoration of the pumping function of the heart or metabolism in cardiomyocytes in the early post-transplant period. Received 6 May 2022. Revised 14 June 2022. Accepted 11 July 2022. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Contribution of the authorsConception and study design: M.O. Zhulkov, D.A. Sirota, I.S. ZykovData collection and analysis: M.O. Zhulkov, I.S. Zykov, A.K. Sabetov, H.A. Agaeva, A.G. Makaev, D.M. Osintsev, A.E. Kalendarev, A.P. Nadeev, V.E. Kliver, A.R. Tarkova, M.A. Ovchinnikova, N.A. Karmadonova, D.V. KhomushkuStatistical analysis: M.O. Zhulkov, A.G. MakaevDrafting the article: M.O. ZhulkovCritical revision of the article: M.O. Zhulkov, D.A. Sirota, I.S. Zykov, A.V. FomichevFinal approval of the version to be published: M.O. Zhulkov, D.A. Sirota, I.S. Zykov, A.K. Sabetov, H.A. Agaeva, A.G. Makaev, D.M. Osintsev, A.E. Kalendarev, A.P. Nadeev, V.E. Kliver, A.R. Tarkova, M.A. Ovchinnikova, A.V. Fomichev, N.A. Karmadonova, D.V. Khomushku

Objective: Identification of the quantitative characteristics of changes in the arterial wall according to ultrasound, CT and MRI; development of the roadmap for the use of radiology diagnostic methods.Material and methods: 548 studies of 483 patients with atherosclerosis were analyzed (15 ultrasound studies, 483 – CTA and 50 – MRI). In the comparison group (n = 17) in patients without atherosclerosis, an analysis of MRI data of the aortic wall was performed. According to CTA, signs of atherosclerotic degeneration were assessed. According to the MRI data, indicators of aortic distensibility, Young’s modulus of the aortic wall (MPa), systolic distension of the aorta (ml), aortic wall enhancement index during contrast enhancement were calculated.Results: During the performance of ultrasound in all cases (n = 15), the analysis of the elastic properties of the aortic wall is difficult due to the artifact from calcification. Adverse CT signs of the occurrence of intraoperative vascular complications: the presence of an intraluminal thrombus, an uneven internal aortic contour of more than half of the circumference with an aortic wall thickness of more than 5 mm. According to MRI data in patients with atherosclerosis, aortic distensibility was reduced to 14.42 ± 2.95%, Young’s modulus for the aortic wall was 0.77 ± 0.26 MPa, the index of contrast enhancement of the aortic wall was 1.73 ± 0.5, the volume of systolic aortic distension was 11.48 ± 1.84 ml. In patients with vascular events in the perioperative period, systolic aortic dilatation was 9.2 ml.Conclusion: The signs which are expedient to consider when making a decision on surgical treatment have been identified. Significant limitations were identified in the assessment of elasticity by ultrasound. The wider use of MRI in atherosclerotic lesions looks promising.