Postoperative and mid-term hemodynamic changes after replacement of the ascending aorta
| Autor: | Roberto Di Bartolomeo, Lucia Salvi, Antonella Zambon, Davide Soranna, Jacopo Alfonsi, Alessandro Pini, Andrea Grillo, Paolo Salvi, Gianfranco Parati, Davide Pacini |
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| Přispěvatelé: | Salvi L., Alfonsi J., Grillo A., Pini A., Soranna D., Zambon A., Pacini D., Di Bartolomeo R., Salvi P., Parati G., Salvi, L., Alfonsi, J., Grillo, A., Pini, A., Soranna, D., Zambon, A., Pacini, D., Di Bartolomeo, R., Salvi, P., Parati, G., Salvi, L, Alfonsi, J, Grillo, A, Pini, A, Soranna, D, Zambon, A, Pacini, D, Di Bartolomeo, R, Salvi, P, Parati, G |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Systole aortic distensibility arterial stiffness ascending aortic aneurysm pulse wave velocity thoracic aortic surgery vascular prosthesis vascular prosthesi Hemodynamics Pulse Wave Analysis 030204 cardiovascular system & hematology 03 medical and health sciences Aortic aneurysm Vascular Stiffness 0302 clinical medicine medicine.artery Internal medicine arterial stiffne Ascending aorta Humans Medicine Arterial Pressure Pulse wave velocity Aorta business.industry Middle Aged medicine.disease Aortic Aneurysm Pulse pressure Blood pressure 030228 respiratory system Case-Control Studies Heart Valve Prosthesis Cardiology cardiovascular system Female Surgery Aortic stiffness Cardiology and Cardiovascular Medicine business |
| Popis: | Objectives To evaluate aortic distensibility and pulse waveform patterns associated with the ascending aortic aneurysm, and to analyze the postoperative and mid-term hemodynamic changes induced by prosthetic replacement of the ascending aorta. Methods Central blood pressure waves were recorded at the carotid artery level by means of a validated transcutaneous arterial tonometer in 30 patients undergoing prosthetic replacement of ascending aortic aneurysm and in 30 control patients. Measurements were obtained the day before surgery and 5 to 7 days and 16 to 20 months after surgery. Results The ascending aortic aneurysm was associated with a less steep slope of early systolic phase of the pressure curve (pulsus tardus) compared with a control group (0.54 ± 0.18 mm Hg/ms vs 0.69 ± 0.26 mm Hg/ms; P = .011). Replacing the ascending aorta with a noncompliant vascular prosthesis steepened the pulse pressure slope during the early systolic phase in the postoperative period (0.77 ± .29 mm Hg/ms), providing values comparable with those of the control group in the mid-term (0.67 ± .20 mm Hg/ms). No change in aortic stiffness was found either postoperatively or in the mid-term after ascending aorta surgical replacement (carotid-femoral pulse wave velocity: preoperative, 9.0 ± 2.6 m/s; postoperative, 9.0 ± 2.9 m/s; mid-term postoperative, 9.3 ± 2.8 m/s). Conclusions This study does not confirm the assumption that substitution of the viscoelastic ascending aorta with a rigid prosthesis can cause serious hemodynamic alterations downstream, because we did not observe a worsening of global aortic distensibility after insertion of a rigid prosthetic aorta. The ascending aortic aneurysm is associated with a pulsus tardus. |
| Databáze: | OpenAIRE |
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