Impact of ascending aortic prosthetic grafts on early postoperative descending aortic biomechanics on cardiac magnetic resonance imaging
| Autor: | Christopher Lau, Richard B. Devereux, Jonathan W. Weinsaft, Maria Chiara Palumbo, Christine Park, Jiwon Kim, Arindam RoyChoudury, Matthew Wingo, Lisa Q. Rong, Leonard N. Girardi, Katherine A Tak, Jeremy R. Leonard, Mary J. Roman, Alberto Redaelli, Hannah W. Mitlak, Mario Gaudino |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Aorta Thoracic Pilot Projects Thoracic aortic aneurysm Aneurysm Cardiac magnetic resonance imaging Internal medicine medicine.artery Ascending aorta medicine Conventional Aortic Surgery Humans Aorta medicine.diagnostic_test business.industry Biomechanics Magnetic resonance imaging General Medicine medicine.disease Magnetic Resonance Imaging Biomechanical Phenomena Aortic Valve Descending aorta Aortic remodelling cardiovascular system Cardiology Surgery Prosthetic graft Cardiology and Cardiovascular Medicine business |
| Zdroj: | Eur J Cardiothorac Surg |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | OBJECTIVES Among patients with ascending thoracic aortic aneurysms, prosthetic graft replacement yields major benefits but risk for recurrent aortic events persists for which mechanism is poorly understood. This pilot study employed cardiac magnetic resonance to test the impact of proximal prosthetic grafts on downstream aortic flow and vascular biomechanics. METHODS Cardiac magnetic resonance imaging was prospectively performed in patients with thoracic aortic aneurysms undergoing surgical (Dacron) prosthetic graft implantation. Imaging included time resolved (4-dimensional) phase velocity encoded cardiac magnetic resonance for flow quantification and cine-cardiac magnetic resonance for aortic wall distensibility/strain. RESULTS Twenty-nine patients with thoracic aortic aneurysms undergoing proximal aortic graft replacement were studied; cardiac magnetic resonance was performed pre- [12 (4, 21) days] and postoperatively [6.4 (6.2, 7.2) months]. Postoperatively, flow velocity and wall shear stress increased in the arch and descending aorta (P CONCLUSIONS Prosthetic graft replacement of the ascending aorta increases downstream aortic wall shear stress and strain. Postoperative increments in descending aortic wall shear stress correlate with reduced ascending aortic distensibility, suggesting that grafts provide a nidus for high energy flow and adverse distal aortic remodelling. |
| Databáze: | OpenAIRE |
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