The influence of mechanical properties on wall stress and distensibility of the dilated ascending aorta Ruth J Okamoto, DSc, Haodong Xu, MD, PhD, Nicholas.

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Presentation transcript:

The influence of mechanical properties on wall stress and distensibility of the dilated ascending aorta Ruth J Okamoto, DSc, Haodong Xu, MD, PhD, Nicholas T Kouchoukos, MD, Marc R Moon, MD, Thoralf M Sundt, MD The Journal of Thoracic and Cardiovascular Surgery Volume 126, Issue 3, Pages 842-850 (September 2003) DOI: 10.1016/S0022-5223(03)00728-1

Figure 1 Cylindrical model of aorta. A, Open cylindrical segment in stress-free configuration, characterized by opening angle α, stress-free inner radius Ri*, outer radius Ro*, and stress-free length Z*. When α > 180° as shown, the inner radius of the closed ring becomes the outer curvature of the open ring, hence Ri* > Ro*. Curved arrows show how the open segment is closed. B, Closed cylinder in unloaded configuration with inner and outer radii Ri and Ro and length Z. C, Deformed cylinder with applied internal pressure Pi and axial stretch λz with inner and outer radii under load of ri and ro. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 842-850DOI: (10.1016/S0022-5223(03)00728-1)

Figure 2 Comparison of response to simulated equibiaxial stretching between patient groups using fitted elastic properties obtained from biaxial test data. A and B, Marfan. C and D, Bicuspid aortic valve (BAV). E and F, Degenerative aneurysm (DA). Fitted data is used to eliminate slight differences in stretching protocols between patients; however, maximum stresses shown correspond closely to stresses reached during actual equibiaxial stretching experiments. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 842-850DOI: (10.1016/S0022-5223(03)00728-1)

Figure 3 Model-predicted mean circumferential stress as a function of predicted lumen diameter for all patient groups: Marfan, open square;BAV, open diamond;DA, open circle. Dashed line shows linear fit to data: σ ̄c,sys(kPa) = −34.564 + 62.3*dsys(cm), R2 = 0.469. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 842-850DOI: (10.1016/S0022-5223(03)00728-1)

Figure 4 A, Mean circumferential stress in the cylindrical model plotted as a function of blood pressure for 4 representative patients. Marfan (39 years): open square; younger BAV (39 years): closed triangle; older BAV (66 years): open triangle; DA (77 years), closed circle. B, Normalized radius (ri/Ri) versus blood pressure for the same patients. Open symbols indicate model predicted values at 10–mm Hg pressure increments. Corresponding closed symbols indicate model-predicted values at each patient's reported preoperative systolic and diastolic blood pressure. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 842-850DOI: (10.1016/S0022-5223(03)00728-1)

Figure 5 Stretch ratios corresponding to systolic and diastolic stress states were determined using fitted elastic properties obtained from biaxial testing. A, Predicted circumferential stretch ratios. B, Axial stretch ratios plotted as a function of age for σc = 262 kPa and σz = 117 kPa. C, Predicted circumferential stretch ratios. D, Axial stretch ratios plotted as a function of age for σc = 130 kPa and σz = 76 kPa. Symbols denote different clinical groups: Marfan (open square),BAV (open diamond), DA (closed circle),and dashed lines show a linear fit of the data as a function of age. E, Mean circumferential (unshaded) and axial (shaded) stretch ratios for each clinical group. F, Change in circumferential stretch ratio between stress states shown in C and A. *Significantly greater change in the younger BAV group compared with all other patient groups. The Journal of Thoracic and Cardiovascular Surgery 2003 126, 842-850DOI: (10.1016/S0022-5223(03)00728-1)