Prosthetic replacement of the aorta is a risk factor for aortic root aneurysm development
Background. Noncompliant prostheses are used in aortic replacement. We hypothesized that this leads to increased distension and wall stress in the aortic root because of the loss of ventriculo arterial coupling. Methods. Pressure relations in the aortic root caused by changes of aortic elasticity si...
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| Veröffentlicht in: | The Annals of thoracic surgery 2002-02, Vol.73 (2), p.455-459 |
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| container_title | The Annals of thoracic surgery |
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| creator | Simon-Kupilik, Natascha Schima, Heinz Huber, Leopold Moidl, Reinhard Wipplinger, Gerhard Losert, Udo Wolner, Ernst Simon, Paul |
| description | Background. Noncompliant prostheses are used in aortic replacement. We hypothesized that this leads to increased distension and wall stress in the aortic root because of the loss of ventriculo arterial coupling.
Methods. Pressure relations in the aortic root caused by changes of aortic elasticity simulating prosthetic aortic replacement were tested in a computer model. We then developed an in vitro model using porcine aortas and performed in vivo validation.
Results. Findings in vitro and in vivo confirmed the predicted changes of the computer model. Pressure amplitude increased significantly by 17% after prosthetic replacement (
p < 0.01). Pressure-time differential (Dp/dt) and dicrotic notch pressure amplitude both increased significantly. Echocardiography demonstrated systolic aortic root distension with percentage area change increasing in vitro from 28.2% ± 9.7% to 35.9% ± 10% (
p < 0.05) and in vivo from 13.3% ± 3.1% to 24.3% ± 3.1% (
p < 0.0001). Aortic root wall stress increased markedly.
Conclusions. Replacement of the aorta with vascular prostheses causes important negative alterations of hemodynamics and increases in wall stress. |
| doi_str_mv | 10.1016/S0003-4975(01)03423-3 |
| format | Article |
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Methods. Pressure relations in the aortic root caused by changes of aortic elasticity simulating prosthetic aortic replacement were tested in a computer model. We then developed an in vitro model using porcine aortas and performed in vivo validation.
Results. Findings in vitro and in vivo confirmed the predicted changes of the computer model. Pressure amplitude increased significantly by 17% after prosthetic replacement (
p < 0.01). Pressure-time differential (Dp/dt) and dicrotic notch pressure amplitude both increased significantly. Echocardiography demonstrated systolic aortic root distension with percentage area change increasing in vitro from 28.2% ± 9.7% to 35.9% ± 10% (
p < 0.05) and in vivo from 13.3% ± 3.1% to 24.3% ± 3.1% (
p < 0.0001). Aortic root wall stress increased markedly.
Conclusions. Replacement of the aorta with vascular prostheses causes important negative alterations of hemodynamics and increases in wall stress.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(01)03423-3</identifier><identifier>PMID: 11845859</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Animals ; Aorta, Thoracic - physiopathology ; Aorta, Thoracic - surgery ; Aortic Aneurysm, Thoracic - etiology ; Aortic Aneurysm, Thoracic - physiopathology ; Aortic Aneurysm, Thoracic - surgery ; Blood Pressure - physiology ; Blood Vessel Prosthesis Implantation ; Computer Simulation ; Elasticity ; Humans ; Models, Cardiovascular ; Postoperative Complications - etiology ; Postoperative Complications - physiopathology ; Postoperative Complications - surgery ; Prosthesis Design ; Swine ; Vascular Resistance - physiology</subject><ispartof>The Annals of thoracic surgery, 2002-02, Vol.73 (2), p.455-459</ispartof><rights>2002 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-e5fe30eeeb29b339dc6425f3e010dc531e143c2b9168a6c946915d7f1df75b593</citedby><cites>FETCH-LOGICAL-c443t-e5fe30eeeb29b339dc6425f3e010dc531e143c2b9168a6c946915d7f1df75b593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003497501034233$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11845859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Simon-Kupilik, Natascha</creatorcontrib><creatorcontrib>Schima, Heinz</creatorcontrib><creatorcontrib>Huber, Leopold</creatorcontrib><creatorcontrib>Moidl, Reinhard</creatorcontrib><creatorcontrib>Wipplinger, Gerhard</creatorcontrib><creatorcontrib>Losert, Udo</creatorcontrib><creatorcontrib>Wolner, Ernst</creatorcontrib><creatorcontrib>Simon, Paul</creatorcontrib><title>Prosthetic replacement of the aorta is a risk factor for aortic root aneurysm development</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. Noncompliant prostheses are used in aortic replacement. We hypothesized that this leads to increased distension and wall stress in the aortic root because of the loss of ventriculo arterial coupling.
Methods. Pressure relations in the aortic root caused by changes of aortic elasticity simulating prosthetic aortic replacement were tested in a computer model. We then developed an in vitro model using porcine aortas and performed in vivo validation.
Results. Findings in vitro and in vivo confirmed the predicted changes of the computer model. Pressure amplitude increased significantly by 17% after prosthetic replacement (
p < 0.01). Pressure-time differential (Dp/dt) and dicrotic notch pressure amplitude both increased significantly. Echocardiography demonstrated systolic aortic root distension with percentage area change increasing in vitro from 28.2% ± 9.7% to 35.9% ± 10% (
p < 0.05) and in vivo from 13.3% ± 3.1% to 24.3% ± 3.1% (
p < 0.0001). Aortic root wall stress increased markedly.
Conclusions. Replacement of the aorta with vascular prostheses causes important negative alterations of hemodynamics and increases in wall stress.</description><subject>Animals</subject><subject>Aorta, Thoracic - physiopathology</subject><subject>Aorta, Thoracic - surgery</subject><subject>Aortic Aneurysm, Thoracic - etiology</subject><subject>Aortic Aneurysm, Thoracic - physiopathology</subject><subject>Aortic Aneurysm, Thoracic - surgery</subject><subject>Blood Pressure - physiology</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Computer Simulation</subject><subject>Elasticity</subject><subject>Humans</subject><subject>Models, Cardiovascular</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Postoperative Complications - surgery</subject><subject>Prosthesis Design</subject><subject>Swine</subject><subject>Vascular Resistance - physiology</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LAzEQhoMotn78BCUn0cNqskm2zUmk-AUFBfXgKWSzE4zuNjVJC_33ZtuiRw9DmJnnncm8CJ1QckkJra5eCCGs4HIkzgm9IIyXrGA7aEiFKIuqFHIXDX-RATqI8TOnZW7vowGlYy7GQg7R-3PwMX1AcgYHmLfaQAezhL3FuYq1D0ljF7HGwcUvbLVJPmCbo2_1Iu8T1jNYhFXscANLaP28H3GE9qxuIxxv30P0dnf7Onkopk_3j5ObaWE4Z6kAYYERAKhLWTMmG1PxUlgGhJLGCEaBcmbKWtJqrCsjeSWpaEaWNnYkaiHZITrbzJ0H_72AmFTnooG2zZ_yi6hGlIuSkXEGxQY0-eQYwKp5cJ0OK0WJ6j1Va09Vb5giVK09VSzrTrcLFnUHzZ9qa2IGrjcA5DOXDoKKxsHMQOMCmKQa7_5Z8QN044bq</recordid><startdate>20020201</startdate><enddate>20020201</enddate><creator>Simon-Kupilik, Natascha</creator><creator>Schima, Heinz</creator><creator>Huber, Leopold</creator><creator>Moidl, Reinhard</creator><creator>Wipplinger, Gerhard</creator><creator>Losert, Udo</creator><creator>Wolner, Ernst</creator><creator>Simon, Paul</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020201</creationdate><title>Prosthetic replacement of the aorta is a risk factor for aortic root aneurysm development</title><author>Simon-Kupilik, Natascha ; Schima, Heinz ; Huber, Leopold ; Moidl, Reinhard ; Wipplinger, Gerhard ; Losert, Udo ; Wolner, Ernst ; Simon, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-e5fe30eeeb29b339dc6425f3e010dc531e143c2b9168a6c946915d7f1df75b593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Animals</topic><topic>Aorta, Thoracic - physiopathology</topic><topic>Aorta, Thoracic - surgery</topic><topic>Aortic Aneurysm, Thoracic - etiology</topic><topic>Aortic Aneurysm, Thoracic - physiopathology</topic><topic>Aortic Aneurysm, Thoracic - surgery</topic><topic>Blood Pressure - physiology</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Computer Simulation</topic><topic>Elasticity</topic><topic>Humans</topic><topic>Models, Cardiovascular</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Postoperative Complications - surgery</topic><topic>Prosthesis Design</topic><topic>Swine</topic><topic>Vascular Resistance - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Simon-Kupilik, Natascha</creatorcontrib><creatorcontrib>Schima, Heinz</creatorcontrib><creatorcontrib>Huber, Leopold</creatorcontrib><creatorcontrib>Moidl, Reinhard</creatorcontrib><creatorcontrib>Wipplinger, Gerhard</creatorcontrib><creatorcontrib>Losert, Udo</creatorcontrib><creatorcontrib>Wolner, Ernst</creatorcontrib><creatorcontrib>Simon, Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Simon-Kupilik, Natascha</au><au>Schima, Heinz</au><au>Huber, Leopold</au><au>Moidl, Reinhard</au><au>Wipplinger, Gerhard</au><au>Losert, Udo</au><au>Wolner, Ernst</au><au>Simon, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prosthetic replacement of the aorta is a risk factor for aortic root aneurysm development</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2002-02-01</date><risdate>2002</risdate><volume>73</volume><issue>2</issue><spage>455</spage><epage>459</epage><pages>455-459</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>Background. Noncompliant prostheses are used in aortic replacement. We hypothesized that this leads to increased distension and wall stress in the aortic root because of the loss of ventriculo arterial coupling.
Methods. Pressure relations in the aortic root caused by changes of aortic elasticity simulating prosthetic aortic replacement were tested in a computer model. We then developed an in vitro model using porcine aortas and performed in vivo validation.
Results. Findings in vitro and in vivo confirmed the predicted changes of the computer model. Pressure amplitude increased significantly by 17% after prosthetic replacement (
p < 0.01). Pressure-time differential (Dp/dt) and dicrotic notch pressure amplitude both increased significantly. Echocardiography demonstrated systolic aortic root distension with percentage area change increasing in vitro from 28.2% ± 9.7% to 35.9% ± 10% (
p < 0.05) and in vivo from 13.3% ± 3.1% to 24.3% ± 3.1% (
p < 0.0001). Aortic root wall stress increased markedly.
Conclusions. Replacement of the aorta with vascular prostheses causes important negative alterations of hemodynamics and increases in wall stress.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>11845859</pmid><doi>10.1016/S0003-4975(01)03423-3</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Animals Aorta, Thoracic - physiopathology Aorta, Thoracic - surgery Aortic Aneurysm, Thoracic - etiology Aortic Aneurysm, Thoracic - physiopathology Aortic Aneurysm, Thoracic - surgery Blood Pressure - physiology Blood Vessel Prosthesis Implantation Computer Simulation Elasticity Humans Models, Cardiovascular Postoperative Complications - etiology Postoperative Complications - physiopathology Postoperative Complications - surgery Prosthesis Design Swine Vascular Resistance - physiology |
| title | Prosthetic replacement of the aorta is a risk factor for aortic root aneurysm development |
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