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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vtio</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник трансплантологии и искусственных органов</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Transplantology and Artificial Organs</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-1191</issn><publisher><publisher-name>Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15825/1995-1191-2021-2-95-103</article-id><article-id custom-type="elpub" pub-id-type="custom">vtio-1200</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ИСКУССТВЕННЫЕ ОРГАНЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ARTIFICIAL ORGANS</subject></subj-group></article-categories><title-group><article-title>Численно-экспериментальное обоснование конструкции транскатетерного протеза клапана аорты</article-title><trans-title-group xml:lang="en"><trans-title>Numerical and experimental justification of transcatheter aortic valve prosthesis design</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Овчаренко</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ovcharenko</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Овчаренко Евгений Андреевич, врач-кибернетик, научный сотрудник лаборатории новых биоматериалов </p><p>Кемерово</p><p>SPIN-код <ext-link xlink:href="http://elibrary.ru/author_info.asp?isold=1" ext-link-type="uri">8947-1636</ext-link></p></bio><bio xml:lang="en"><p>Ovcharenko Evgeny A</p><p>Kemerovo</p></bio><email xlink:type="simple">ov.evgene@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Клышников</surname><given-names>К. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Klyshnikov</surname><given-names>K. U.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Клышников Кирилл Юрьевич   </p><p>650002, Кемерово, Сосновый бульвар, д. 6</p></bio><bio xml:lang="en"><p>Kirill U. Klyshnikov</p><p>6, Sosnovy Boulevard, Kemerovo, 650002</p></bio><email xlink:type="simple">klyshnikovk@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шилов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shilov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шилов Александр Александрович</p><p>Кемерово</p></bio><bio xml:lang="en"><p>Shilov Alexander A. </p><p>Kemerovo</p></bio><email xlink:type="simple">shilik@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Щеглова</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Scheglova</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Новосибирск</p></bio><bio xml:lang="en"><p>Novosibirsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Глушкова</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Glushkova</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Глушкова Татьяна Владимировна</p><p>Кемерово</p></bio><bio xml:lang="en"><p>Glushkova Tatiana V. </p><p>Kemerovo</p></bio><email xlink:type="simple">rubio.tvg@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нуштаев</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Nushtaev</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Нуштаев Дмитрий Владимирович</p><p>127299, Москва, Россия, ул. Клары Цеткин, 2</p></bio><bio xml:lang="en"><p>Nushtaev Dmitry V.</p><p>127299, Moscow, Russia, ul. Klara Zetkin, 2</p></bio><email xlink:type="simple">nyshtaev@rambler.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Барбараш</surname><given-names>Л. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Barbarash</surname><given-names>L. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Барбараш Леонид Семенович</p><p>Кемерово</p></bio><bio xml:lang="en"><p>Barbarash Leonid S. </p><p>Kemerovo</p></bio><email xlink:type="simple">director@kemcardio.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Institute for Complex Issues of Cardiovascular Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ООО «Логикс»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>LOGEEKS Ltd.</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ЗАО «Северсталь Менеджмент»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Severstal Management</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>09</day><month>06</month><year>2021</year></pub-date><volume>23</volume><issue>2</issue><fpage>95</fpage><lpage>103</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Овчаренко Е.А., Клышников К.Ю., Шилов А.А., Щеглова Н.А., Глушкова Т.В., Нуштаев Д.В., Барбараш Л.С., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Овчаренко Е.А., Клышников К.Ю., Шилов А.А., Щеглова Н.А., Глушкова Т.В., Нуштаев Д.В., Барбараш Л.С.</copyright-holder><copyright-holder xml:lang="en">Ovcharenko E.A., Klyshnikov K.U., Shilov A.A., Scheglova N.A., Glushkova T.V., Nushtaev D.V., Barbarash L.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.transpl.ru/vtio/article/view/1200">https://journal.transpl.ru/vtio/article/view/1200</self-uri><abstract><p>Целью исследования явилось обоснование конструкции самораскрывающегося транскатетерного протеза клапана аорты на основе биоматериала, стабилизированного диглицидиловым эфиром этиленгликоля, с использованием численного моделирования и серии натурных экспериментов с рабочими прототипами для определения состоятельности предложенных конструктивных решений.</p><sec><title>Материал и методы</title><p>Материал и методы. В работе использовали численные компьютерные модели разрабатываемого протеза клапана аорты, предназначенного для транскатетерной имплантации, а также прототипы наиболее перспективных концептов для серии натурных испытаний. Компьютерные трехмерные модели подвергали численному анализу в среде Abaqus/ CAE (Dassault Systemes, Франция) на основе метода конечных элементов с итеративной оптимизацией дизайна и повторным проведением численных экспериментов. Физические прототипы транскатетерного протеза подвергали серии механических испытаний на осевое и радиальное сжатие, а также испытаниям на гидродинамическом стенде Vivitro (Vivitro Labs, Канада) в условиях имитации нормального потока. Все исследования проводили в сравнительном аспекте с аналогичным транскатетерным протезом клапана аорты (контроль) – биопротезом CoreValve™ (Medtronic, Inc., США).</p></sec><sec><title>Результаты</title><p>Результаты. Компьютерное моделирование демонстрирует значения напряженно-деформированного состояния, существенно не превышающие критических уровней (628 и 756 МПа против порогового значения 1080 МПа) для двух основных концептов опорных каркасов. Усталостная прочность на основе вычисления среднего и переменного напряжений, соответствующих нормо- и гипертоническим состояниям на основе диаграмм Гудмана, не выявила превышения пороговых значений – области разрушения после 200 млн циклов. Гидродинамические характеристики рабочих прототипов, изготовленных на основе компьютерных моделей, соответствуют данным тестирования клинического биопротеза CoreValve™: полученная эффективная площадь отверстия составила 1,97 см2, средний транспротезный градиент 8,9 мм рт. ст., объем регургитации 2,2–4,1 мл/цикл в зависимости от модели прототипа.</p></sec><sec><title>Заключение</title><p>Заключение. В целом проведенные экспериментальные работы показали состоятельность концептов, в т. ч. с позиции реализации створчатого аппарата на основе ксенотканей, обработанных диглицидиловым эфиром этиленгликоля.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Objective</title><p>Objective: to justify the design of a self-expanding transcatheter aortic valve prosthesis based on a biomaterial stabilized with ethylene glycol diglycidyl ether using numerical simulation and a series of field experiments with working prototypes to determine the consistency of the proposed design solutions.</p></sec><sec><title>Material and methods</title><p>Material and methods. Numerical computer models of a developed aortic valve prosthesis intended for transcatheter implantation, as well as prototypes of the most promising concepts for a series of field tests, were used in the work. Computer 3D models were subjected to numerical analysis in the Abaqus/CAE environment (Dassault Systemes, France) based on the finite element method with iterative design optimization and repeated numerical experiments. Physical prototypes of the transcatheter prosthesis were subjected to a series of mechanical tests for axial and radial compression, as well as tests on a Vivitro hydrodynamic stand (Vivitro Labs, Canada) under simulated normal flow. All studies were carried out in a comparative aspect with a similar transcatheter aortic valve prosthesis (control), the CoreValve™ bioprosthesis (Medtronic, Inc., USA).</p></sec><sec><title>Results</title><p>Results. Computer simulation demonstrates the stress-strain state values that do not significantly exceed the critical levels (628 and 756 MPa versus the threshold value 1080 MPa) for two basic concepts of support frames. The fatigue strength based on the calculation of the mean and alternating stresses corresponding to normo- and hypertensive states based on the Goodman diagrams, did not reveal any evidence that the threshold values (destruction area after 200 million cycles) were exceeded. The hydrodynamic characteristics of working prototypes made on the basis of computer models correspond to the testing data of CoreValve™ clinical bioprosthesis: the effective orifice area was 1.97 cm2, the mean transprosthetic gradient was 8.9 mm Hg, the regurgitant volume was 2.2–4.1 mL per cycle depending on the prototype model.</p></sec><sec><title>Conclusion</title><p>Conclusion. Generally, experiments carried out showed the consistency of the concepts, including from the point of view of implementation of the leaflet apparatus based on xenogeneic tissues treated with ethylene glycol diglycidyl ether.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>транскатетерный протез</kwd><kwd>аортальный стеноз</kwd><kwd>метод конечных элементов</kwd><kwd>гидродинамика</kwd><kwd>численное моделирование</kwd></kwd-group><kwd-group xml:lang="en"><kwd>transcatheter prosthesis</kwd><kwd>aortic stenosis</kwd><kwd>finite element method</kwd><kwd>fluid dynamics</kwd><kwd>numerical simulation</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование выполнено за счет гранта Российского научного фонда проект № 18-75-10061 по теме «Исследование и реализация концепции роботизированного малоинвазивного протезирования клапана аорты».</funding-statement><funding-statement xml:lang="en">The study was supported by a grant from the Russian Science Foundation, project No. 18-75-10061 on the topic "Research and implementation of the concept of robotic minimally invasive aortic valve replacement."</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kamioka N, Wells J, Keegan P, Lerakis S, Binongo J, Corrigan F et al. Predictors and clinical outcomes of nextday discharge after minimalist transfemoral transcatheter aortic valve replacement. JACC Cardiovasc Interv. 2018; 11: 107–115. doi: 10.1016/j.jcin.2017.10.021.</mixed-citation><mixed-citation xml:lang="en">Kamioka N, Wells J, Keegan P, Lerakis S, Binongo J, Corrigan F et al. Predictors and clinical outcomes of nextday discharge after minimalist transfemoral transcatheter aortic valve replacement. JACC Cardiovasc Interv. 2018; 11: 107–115. doi: 10.1016/j.jcin.2017.10.021.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Rodriguez-Gabella T, Voisine P, Puri R, Pibarot P, Rodes-Cabau J. Aortic bioprosthetic valve durability: incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration. J Am Coll Cardiol. 2017; 70: 1013–1028. doi: 10.1016/j.jacc.2017.07.715.</mixed-citation><mixed-citation xml:lang="en">Rodriguez-Gabella T, Voisine P, Puri R, Pibarot P, Rodes-Cabau J. Aortic bioprosthetic valve durability: incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration. J Am Coll Cardiol. 2017; 70: 1013–1028. doi: 10.1016/j.jacc.2017.07.715.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Wang M, Furnary AP, Li HF, Grunkemeier GL. Bioprosthetic aortic valve durability: a metaregression of published studies. Ann Thorac Surg. 2017; 104: 1080–1087. doi: 10.1016/j.athoracsur.2017.02.011.</mixed-citation><mixed-citation xml:lang="en">Wang M, Furnary AP, Li HF, Grunkemeier GL. Bioprosthetic aortic valve durability: a metaregression of published studies. Ann Thorac Surg. 2017; 104: 1080–1087. doi: 10.1016/j.athoracsur.2017.02.011.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Dasi LP, Hatoum H, Kheradvar A, Zareian R, Alavi SH, Sun W et al. On the mechanics of transcatheter aortic valve replacement. Ann Biomed Eng. 2017; 45: 310–331. doi: 10.1007/s10439-016-1759-3.</mixed-citation><mixed-citation xml:lang="en">Dasi LP, Hatoum H, Kheradvar A, Zareian R, Alavi SH, Sun W et al. On the mechanics of transcatheter aortic valve replacement. Ann Biomed Eng. 2017; 45: 310–331. doi: 10.1007/s10439-016-1759-3.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Журавлева ИЮ, Карпова ЕВ, Опарина ЛА, Кабос Н, Ксенофонтов АЛ, Журавлева АС и др. Ксеноперикард, консервированный ди- и пентаэпоксидами: молекулярные механизмы сшивки и механические свойства биоматериала. Патология кровообращения и кардиохирургия. 2018; 22 (3): 56–68. doi: 10.21688/1681-3472-2018-3-56-68.</mixed-citation><mixed-citation xml:lang="en">Zhuravleva IYu, Karpova EV, Oparina LA, Kabos N, Ksenofontov AL, Zhuravleva AS et al. Xenopericardum, preserved by diand pentaepoxides: molecular mechanisms of crosslinking and mechanical properties of biomaterial. Circulatory pathology and cardiac surgery. 2018; 22 (3): 56–68. doi: 10.21688/1681-3472-2018-3-56-68. [In Russ, English abstract].</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Барбараш ЛС, Рогулина НВ, Рутковская НВ, Одаренко ЮН, Кокорин СГ. Опыт применения эпоксиобработанных биологических протезов при пороке митрального клапана у пациентов моложе 65 лет. Грудная и сердечно-сосудистая хирургия. 2019; 61 (2): 114–122. doi: 10.24022/0236-2791-2019-61-2-114-122.</mixed-citation><mixed-citation xml:lang="en">Barbarash LS, Rogulina NV, Rutkovskaya NV, Odarenko YuN, Kokorin SG. Experience with the use of epoxy-treated biological prostheses in mitral valve disease in patients younger than 65 years of age. Thoracic and cardiovascular surgery. 2019; 61 (2): 114– 122. doi: 10.24022/0236-2791-2019-61-2-114-122. [In Russ, English abstract].</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Rotman OM, Bianchi M, Ghosh RP, Kovarovic B, Bluestein D. Principles of TAVR valve design, modelling, and testing. Expert Rev Med Devices. 2018; 15 (11): 771–791. doi: 10.1080/17434440.2018.1536427.</mixed-citation><mixed-citation xml:lang="en">Rotman OM, Bianchi M, Ghosh RP, Kovarovic B, Bluestein D. Principles of TAVR valve design, modelling, and testing. Expert Rev Med Devices. 2018; 15 (11): 771–791. doi: 10.1080/17434440.2018.1536427.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Cahill TJ, Chen M, Hayashida K, Latib A, Modine T, Piazza N et al. Transcatheter aortic valve implantation: current status and future perspectives. Eur Heart J. 2018; 39 (28): 2625–2634. doi: 10.1093/eurheartj/ehy244.</mixed-citation><mixed-citation xml:lang="en">Cahill TJ, Chen M, Hayashida K, Latib A, Modine T, Piazza N et al. Transcatheter aortic valve implantation: current status and future perspectives. Eur Heart J. 2018; 39 (28): 2625–2634. doi: 10.1093/eurheartj/ehy244.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Богачев-Прокофьев АВ, Журавлева ИЮ, Шарифулин РМ, Железнев СИ, Демидов ДП, Кливер ЕЭ, Караськов АМ. Имплантация in vitro первого отечественного транскатетерного протеза в нативный митральный клапан. Патология кровообращения и кардиохирургия. 2018; 22 (1): 22–28.</mixed-citation><mixed-citation xml:lang="en">Bogachev-Pro kofiev AV, Zhuravleva IYu, Sharifulin RM, Zheleznev SI, Demidov DP, Kliver EE, Karaskov AM. In vitro implantation of the first domestic transcatheter prosthesis in the native mitral valve. Circulatory pathology and cardiac surgery. 2018; 22 (1): 22–28. [In Russ, English abstract].</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Rotman OM, Kovarovic B, Chiu WC, Bianchi M, Marom G, Slepian MJ, Bluestein D. Novel Polymeric Valve for Transcatheter Aortic Valve Replacement Applications: In vitro Hemodynamic Study. Ann Biomed Eng. 2019; 47 (1): 113–125. doi: 10.1007/s10439-018-02119-7.</mixed-citation><mixed-citation xml:lang="en">Rotman OM, Kovarovic B, Chiu WC, Bianchi M, Marom G, Slepian MJ, Bluestein D. Novel Polymeric Valve for Transcatheter Aortic Valve Replacement Applications: In vitro Hemodynamic Study. Ann Biomed Eng. 2019; 47 (1): 113–125. doi: 10.1007/s10439-018-02119-7.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Marrey R, Baillargeon B, Dreher ML, Weaver JD, Nagaraja S, Rebelo N, Gong XY. Validating Fatigue Safety Factor Calculation Methods for Cardiovascular Stents. J Biomech Eng. 2018; 140 (6): 10.1115/1.4039173. doi: 10.1115/1.4039173.</mixed-citation><mixed-citation xml:lang="en">Marrey R, Baillargeon B, Dreher ML, Weaver JD, Nagaraja S, Rebelo N, Gong XY. Validating Fatigue Safety Factor Calculation Methods for Cardiovascular Stents. J Biomech Eng. 2018; 140 (6): 10.1115/1.4039173. doi: 10.1115/1.4039173.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Tzamtzis S, Viquerat J, Yap J, Mullen MJ, Burriesci G. Numerical analysis of the radial force produced by the Medtronic-CoreValve and Edwards-SAPIEN after transcatheter aortic valve implantation (TAVI). Med Eng Phys. 2013; 35 (1): 125–130. doi: 10.1016/j.medengphy.2012.04.009.</mixed-citation><mixed-citation xml:lang="en">Tzamtzis S, Viquerat J, Yap J, Mullen MJ, Burriesci G. Numerical analysis of the radial force produced by the Medtronic-CoreValve and Edwards-SAPIEN after transcatheter aortic valve implantation (TAVI). Med Eng Phys. 2013; 35 (1): 125–130. doi: 10.1016/j.medengphy.2012.04.009.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Robertson SW, Pelton AR, Ritchie RO. Mechanical fatigue and fracture of Nitinol. International Materials Reviews. 2012; 57 (1): 1–37. doi: 10.1179/1743280411Y.0000000009.</mixed-citation><mixed-citation xml:lang="en">Robertson SW, Pelton AR, Ritchie RO. Mechanical fatigue and fracture of Nitinol. International Materials Reviews. 2012; 57 (1): 1–37. doi: 10.1179/1743280411Y.0000000009.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Alfadhli J, Jeraq M, Singh V, Martinez C. Updates on transcatheter aortic valve replacement: Techniques, complications, outcome, and prognosis. J Saudi Heart Assoc. 2018; 30 (4): 340–348. doi: 10.1016/j.jsha.2018.07.002.</mixed-citation><mixed-citation xml:lang="en">Alfadhli J, Jeraq M, Singh V, Martinez C. Updates on transcatheter aortic valve replacement: Techniques, complications, outcome, and prognosis. J Saudi Heart Assoc. 2018; 30 (4): 340–348. doi: 10.1016/j.jsha.2018.07.002.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Клышников КЮ, Овчаренко ЕА, Мальцев ДА, Журавлева ИЮ. Сравнительная характеристика гидродинамических показателей биопротезов клапанов сердца «ЮниЛайн» и «ПериКор». Клиническая физиология кровообращения. 2013; 1: 45–51.</mixed-citation><mixed-citation xml:lang="en">Klyshnikov KYu, Ovcharenko EA, Maltsev DA, Zhuravleva IYu. Comparative characteristics of hydrodynamic indicators of bioprostheses of heart valves «UniLine» and «PeriCor». Clinical physiology of blood circulation. 2013; 1: 45–51. [In Russ, English abstract].</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Marquez S, Hon RT, Yoganathan AP. Comparative hydrodynamic evaluation of bioprosthetic heart valves. J Heart Valve Dis. 2001; 10 (6): 802–811.</mixed-citation><mixed-citation xml:lang="en">Marquez S, Hon RT, Yoganathan AP. Comparative hydrodynamic evaluation of bioprosthetic heart valves. J Heart Valve Dis. 2001; 10 (6): 802–811.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
