Biomechanics of Failed Pulmonary Autografts Compared With Normal Pulmonary Roots
| Autor: | Ad J.J.C. Bogers, Aart Mookhoek, Heide Kuang, Paul H. Schoof, Elaine E. Tseng, Liang Ge, Sam Chitsaz, Johanna J.M. Takkenberg, Kapil Krishnan |
|---|---|
| Přispěvatelé: | Cardiothoracic Surgery |
| Rok vydání: | 2016 |
| Předmět: |
Male
Aortic valve medicine.medical_treatment Heart Valve Diseases Blood Pressure 030204 cardiovascular system & hematology medicine.disease_cause Weight-bearing Weight-Bearing Postoperative Complications 0302 clinical medicine Bicuspid Aortic Valve Disease Heart Valve Prosthesis Implantation Anthropometry Ross procedure Biomechanics musculoskeletal system surgical procedures operative medicine.anatomical_structure Aortic Valve Perspective Female Cardiology and Cardiovascular Medicine Compliance Dilatation Pathologic Reoperation musculoskeletal diseases Pulmonary and Respiratory Medicine medicine.medical_specialty Aortic Valve Insufficiency Pulmonary Artery Transplantation Autologous 03 medical and health sciences Vascular Stiffness Tensile Strength medicine.artery Journal Article medicine Humans Pulmonary Valve business.industry Surgery Compliance (physiology) Blood pressure 030228 respiratory system Pulmonary valve Pulmonary artery Stress Mechanical business |
| Zdroj: | Annals of Thoracic Surgery, 102(6), 1996-2002. Elsevier Inc. Annals of Thoracic Surgery, 102(6), 1996. Elsevier USA |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2016.05.010 |
| Popis: | Background Progressive dilatation of pulmonary autografts after the Ross operation may reflect inadequate remodeling of the native pulmonary root to adapt to systemic circulation. Understanding the biomechanics of autograft root dilatation may aid designing strategies to prevent dilatation. We have previously characterized normal human pulmonary root material properties; however, the mechanical properties of failed autografts are unknown. In this study, failed autograft roots explanted during reoperation were acquired, and their material properties were determined. Methods Failed pulmonary autograft specimens were obtained from patients undergoing reoperation after the Ross operation. Fresh human native pulmonary roots were obtained from the transplant donor network as controls. Biaxial stretch testing was performed to determine tissue mechanical properties. Tissue stiffness was determined at patient-specific physiologic stresses at pulmonary pressures. Results Nonlinear stress-strain response was present in both failed autografts and normal pulmonary roots. Explanted pulmonary autografts were less stiff than were their native pulmonary root counterparts at 8 mm Hg (134 ± 42 vs 175 ± 49 kPa, respectively) ( p = 0.086) and 25 mm Hg (369 ± 105 vs 919 ± 353 kPa, respectively) ( p = 0.006). Autograft wall stiffness at both 8 and 25 mm Hg was not correlated with age at the Ross procedure ( p = 0.898 and p = 0.813, respectively) or with time in the systemic circulation ( p = 0.609 and p = 0.702, respectively). Conclusions Failed pulmonary autografts retained nonlinear response to mechanical loading typical of healthy human arterial tissue. Remodeling increased wall thickness but decreased wall stiffness in failed autografts. Increased compliance may explain progressive autograft root dilatation in autograft failures. |
| Databáze: | OpenAIRE |
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