Role of Re-entry Tears on the Dynamics of Type B Dissection Flap
| Autor: | Joshua Krieger, Matthew J. Phillips, Sean Chambers, Stéphan Haulon, Ghassan S. Kassab, Saranya Canchi, Xiaomei Guo, Blayne A. Roeder, Zachary C. Berwick, Jarin Kratzberg |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Swine 0206 medical engineering Biomedical Engineering 02 engineering and technology 030204 cardiovascular system & hematology Article Clinical FDR Strain 03 medical and health sciences 0302 clinical medicine Medicine Animals Humans Acute aortic dissection Aged Aortic dissection Aortic Aneurysm Thoracic business.industry Re entry Anatomy Middle Aged Circumference Type b dissection medicine.disease 020601 biomedical engineering Pulse pressure Dilation Pulse duplicator Aortic Dissection Lumen pressure Tears Female business Ex vivo model Lumen (unit) |
| Zdroj: | Annals of Biomedical Engineering |
| ISSN: | 1573-9686 0090-6964 |
| Popis: | Mortality during follow-up after acute Type B aortic dissection is substantial with aortic expansion observed in over 59% of the patients. Lumen pressure differential is considered a prime contributing factor for aortic dilation after propagation. The objective of the study was to evaluate the relationship between changes in vessel geometry with and without lumen pressure differential post propagation in an ex vivo porcine model with comparison with patient clinical data. A pulse duplicator system was utilized to propagate the dissection within descending thoracic porcine aortic vessels for set proximal (%circumference of the entry tear: 40%, axial length: 2 cm) and re-entry (50% of distal vessel circumference) tear geometry. Measurements of lumen pressure differential were made along with quantification of vessel geometry (n = 16). The magnitude of mean lumen pressure difference measured after propagation was low (~ 5 mmHg) with higher pressures measured in false lumen and as anticipated the pressure difference approached zero after the creation of distal re-entry tear. False lumen Dissection Ratio (FDR) defined as arc length of dissected wall divided by arc length of dissection flap, had mean value of 1.59 ± 0.01 at pressure of 120/80 mmHg post propagation with increasing values with increase in pulse pressure that was not rescued with the creation of distal re-entry tear (p |
| Databáze: | OpenAIRE |
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