P129. Ex Vivo Mechanical Properties of Aortic Wall in Acute Dissection Compared to Non-dissected Aorta
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
IRCCS Foundation Hospital "San Matteo"-Pavia-Italy
Milano, Milan
Italy - Contact Me
Consultant Cardiac Surgeon since 2005
MD in 1990
PhD in 2010
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
Background
Acute aortic syndrome is a catastrophic event still characterized by high mortality even in case of successful prompt surgical treatment. Many authors evaluated biomechanical properties of aortic wall from "ex vivo" specimens in order to better clarify the physiopathology of aortic diseases and identify potential predictor risk factors for acute aortic complications. Significant limitation, so far, has been the lack of a "control group", being the majority of specimens harvested during scheduled aortic surgery. In this study we report our extensive experience in evaluation of biomechanical properties of aortic wall including specimens from patients experiencing acute aortic dissection and patients without aortic diseases
Materials and Methods
Aortic wall specimens were obtained in 113 patients who underwent ascending aorta replacement for chronic aortic aneurysm (NDAA: 73pts-64%), genetic aortic disease (GEN: 9pts–8%), acute aortic dissection (AAD: 11pts-10%) or heart transplantation (CG: 20pts- 17%). Mechanical uniaxial tensile ultimate stress test were performed on the fresh "ex vivo" sample within 24 hours from the harvesting measuring 3 parameters: Peek strain (Pstr: marker of aortic wall elasticity); Peek Stress (PS:marker of aortic wall strength) and Maximum elastic modulus (MEM: marker of aortic wall stiffness or resistance to deformation).
Results
Comparative analysis of overall mechnaical properties showed no significant differences between non dissected and dissected aorta. Control group, on other hands showed more preserved elasticity and strength (Fig 1A). Preserved mechanical properties of aortic wall in acute dissection compared to non-dissected disease was confirmed regardless aortic region and direction of mechanical stress (Fig 1B). Both Elasticity and Strenght of aortic wall were overall improved in specimens from control group (red square) especially in posterior wall (Fig 1C).
Conclusions
Our study on mechanical properties included patients with acute dissection and a control group without aortic dilatation. Control group showed indeed the better elasticity and strength of aortic wall thus confirming that impaired mechanical properties are characteristics of dilated aorta. Preserved mechanical properties in undamaged wall of dissected patients showed, however, that acute dissection is characterized by a focal fragility more than a diffuse impaired mechanical properties of aortic wall.
Authors
Pasquale Totaro (1), Ferdinando Auricchio (2), Simone Morganti (2), Stefano Pelenghi (1)
Institutions
(1) IRCCS Foundation Hospital San Matteo, Pavia, PV, (2) University of Pavia, Pavia, PV
Acute aortic syndrome is a catastrophic event still characterized by high mortality even in case of successful prompt surgical treatment. Many authors evaluated biomechanical properties of aortic wall from "ex vivo" specimens in order to better clarify the physiopathology of aortic diseases and identify potential predictor risk factors for acute aortic complications. Significant limitation, so far, has been the lack of a "control group", being the majority of specimens harvested during scheduled aortic surgery. In this study we report our extensive experience in evaluation of biomechanical properties of aortic wall including specimens from patients experiencing acute aortic dissection and patients without aortic diseases
Materials and Methods
Aortic wall specimens were obtained in 113 patients who underwent ascending aorta replacement for chronic aortic aneurysm (NDAA: 73pts-64%), genetic aortic disease (GEN: 9pts–8%), acute aortic dissection (AAD: 11pts-10%) or heart transplantation (CG: 20pts- 17%). Mechanical uniaxial tensile ultimate stress test were performed on the fresh "ex vivo" sample within 24 hours from the harvesting measuring 3 parameters: Peek strain (Pstr: marker of aortic wall elasticity); Peek Stress (PS:marker of aortic wall strength) and Maximum elastic modulus (MEM: marker of aortic wall stiffness or resistance to deformation).
Results
Comparative analysis of overall mechnaical properties showed no significant differences between non dissected and dissected aorta. Control group, on other hands showed more preserved elasticity and strength (Fig 1A). Preserved mechanical properties of aortic wall in acute dissection compared to non-dissected disease was confirmed regardless aortic region and direction of mechanical stress (Fig 1B). Both Elasticity and Strenght of aortic wall were overall improved in specimens from control group (red square) especially in posterior wall (Fig 1C).
Conclusions
Our study on mechanical properties included patients with acute dissection and a control group without aortic dilatation. Control group showed indeed the better elasticity and strength of aortic wall thus confirming that impaired mechanical properties are characteristics of dilated aorta. Preserved mechanical properties in undamaged wall of dissected patients showed, however, that acute dissection is characterized by a focal fragility more than a diffuse impaired mechanical properties of aortic wall.
Authors
Pasquale Totaro (1), Ferdinando Auricchio (2), Simone Morganti (2), Stefano Pelenghi (1)
Institutions
(1) IRCCS Foundation Hospital San Matteo, Pavia, PV, (2) University of Pavia, Pavia, PV
Presentation Duration
PODS will be on display in the exhibit hall for the duration of the meeting during exhibit hall hours. PODS will also be available for viewing on the meeting website. There is no formal presentation associated with your POD, but we encourage you to visit the PODS area during breaks to connect with those viewing.