Salvatore Pasta, PhD, Julie A. Phillippi, PhD, Thomas G

Slides:

Advertisements

Similar presentations

University of Pittsburgh Vascular Bioengineering Laboratory Departments of Surgery and Bioengineering and the McGowan Institute for Regenerative Medicine.

Advertisements

Biomechanical implications of the congenital bicuspid aortic valve: A finite element study of aortic root function from in vivo data Carlo A. Conti,

Of mice and men and surgical transcatheter aortic valve insertion

Lars G. Svensson, MD, PhD, Eugene H. Blackstone, MD

Management of the moderately dilated sinus of Valsalva: To cut or not to cut? Rita Karianna Milewski, MD, PhD, Andreas Habertheuer, MD, PhD, Joseph E.

Pulmonary valve replacement in repaired tetralogy of Fallot by left thoracotomy avoid ascending aorta injury Roland Henaine, MD, Naoki Yoshimura, MD,

Long-term prognosis of ascending aortic aneurysm after aortic valve replacement for bicuspid versus tricuspid aortic valve stenosis Evaldas Girdauskas,

Replacement of the ascending aorta in bicuspid aortic valve disease: Where do we draw the line? Thoralf M. Sundt, MD The Journal of Thoracic and Cardiovascular.

Stephen H. McKellar, MD, David J

Biomechanical Properties of the Thoracic Aneurysmal Wall: Differences Between Bicuspid Aortic Valve and Tricuspid Aortic Valve Patients Caroline Forsell,

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

New graft formulation and modification of the David reimplantation technique Thomas G. Gleason, MD The Journal of Thoracic and Cardiovascular Surgery

Differential Tensile Strength and Collagen Composition in Ascending Aortic Aneurysms by Aortic Valve Phenotype Joseph E. Pichamuthu, MS, Julie A. Phillippi,

Restricted cusp motion in right-left type of bicuspid aortic valves: A new risk marker for aortopathy Alessandro Della Corte, MD, PhD, Ciro Bancone,

The patient said he would rather die: Should you let him?

Bicuspid aortic valve aortopathy: One size fits all?

Determination of the elastic modulus of ascending thoracic aortic aneurysm at different ranges of pressure using uniaxial tensile testing Khalil Khanafer,

Adventitial elastolysis is a primary event in aneurysm formation

Roland Assi, MD, MMS, Wilson Y. Szeto, MD

Risk-corrected impact of mechanical versus bioprosthetic valves on long-term mortality after aortic valve replacement Ole Lund, MD, PhD, Martin Bland,

Josephina Haunschild, MD, Isabel N

The lord of the rings Antonio Miceli, MD, PhD

Effects of Aneurysm on the Mechanical Properties and Histologic Structure of Aortic Sinuses Eleftherios P. Kritharis, PhD, Dimitrios C. Iliopoulos, MD,

Patient selection could be the Holy Grail of thoracic endovascular aortic repair for chronic dissecting aneurysm Ourania Preventza, MD, Peter Chen, MD

Effect of aneurysm on the tensile strength and biomechanical behavior of the ascending thoracic aorta David A Vorp, PhD, Brian J Schiro, BS, Marek P.

Support Your Specialty

Echocardiography underestimates the aortic root diameter in patients with bicuspid aortic valve, but short-axis imaging can help Hector I. Michelena,

Dilatation of the Remaining Aorta After Aortic Valve or Aortic Root Replacement in Patients With Bicuspid Aortic Valve: A 5-Year Follow-Up Nada Abdulkareem,

Hans-Hinrich Sievers, MD

Bicuspid Aortic Valve Morphotype Correlates With Regional Antioxidant Gene Expression Profiles in the Proximal Ascending Aorta Julie A. Phillippi, PhD,

Ascending aortopathy with bicuspid aortic valve: More, but not enough, evidence for the hemodynamic theory William M. DeCampli, MD, PhD The Journal.

Biomechanical implications of the congenital bicuspid aortic valve: A finite element study of aortic root function from in vivo data Carlo A. Conti,

The aortic valve–sparing operation

Maria A. Cohen, BA, Scott R. Owens, MD, Bo Yang, MD, PhD

Surgery for aortic and mitral valve disease in the United States: A trend of change in surgical practice between 1998 and 2005 Scott D. Barnett, PhD,

The Journal of Thoracic and Cardiovascular Surgery

Aortic valve reconstruction using autologous pericardium for patients aged less than 60 years Shigeyuki Ozaki, MD, PhD, Isamu Kawase, MD, PhD, Hiromasa.

Valve-sparing root reimplantation and leaflet repair in a bicuspid aortic valve: Comparison with the 3-cusp David procedure Joseph E. Bavaria, MD, Nimesh.

Fenton H. McCarthy, MD, MS, Nimesh D. Desai, MD, PhD

Sinus of Valsalva aneurysms: Stabilizing the repair destabilizing the aortic valve? M. Sertaç Çiçek, MD, FACC The Journal of Thoracic and Cardiovascular.

David valve-sparing aortic root replacement: Equivalent mid-term outcome for different valve types with or without connective tissue disorder John-Peder.

Replicating the success of mitral valve repair in the aortic valve

A fate worse than death Jennifer S. Lawton, MD

Cardiac surgery in patients with a porcelain aorta

Commentary: Ongoing advancements in the understanding of tricuspid valve dynamics and functional geometry Daniel J.P. Burns, MD, MPhil The Journal of.

Aortic dimensions in patients with bicuspid and tricuspid aortic valves Veronica Jackson, MD, Christian Olsson, MD, PhD, Per Eriksson, PhD, Anders Franco-Cereceda,

Patrick T. Roughneen, MD, Grant T. Fankhauser, MD, Abe DeAnda, MD

Altered Oxidative Stress Responses and Increased Type I Collagen Expression in Bicuspid Aortic Valve Patients Julie A. Phillippi, PhD, Michael A. Eskay,

Functional tricuspid pathology: To treat or not to treat

Concomitant replacement of the ascending aorta is free—for some

In pregnancy, aortic tissue is the issue

Rapid and safe direct cannulation of the true lumen of the ascending aorta in acute type A aortic dissection Heinz Jakob, MD, PhD, Konstantinos Tsagakis,

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

Severe tricuspid or mitral regurgitation in inoperable patients with aortic stenosis. Can we leave them alone? Juan A. Crestanello, MD The Journal of.

Valve-sparing root replacement: Still so much to learn

Bicuspid aortopathy: Seeing the forest for the trees

To pleat or not to pleat…is that the question?

Matrix metalloproteinase 14 and 19 expression is associated with thoracic aortic aneurysms Veronica Jackson, MD, Therese Olsson, BMA, Sanela Kurtovic,

Prognosis of patients undergoing emergency surgery for type A acute aortic dissection without exclusion of the intimal tear Satoshi Unosawa, MD, PhD,

Toward a more rational approach in treating type B aortic dissection

Respect the aorta The Journal of Thoracic and Cardiovascular Surgery

Aortic annuloplasty and valve-sparing root replacement: Details of the primary suture line Thomas G. Gleason, MD The Journal of Thoracic and Cardiovascular.

Grant T. Fankhauser, MD, Abe DeAnda, MD, Patrick T. Roughneen, MD

Ascending thoracic aortic aneurysms are associated with compositional remodeling and vessel stiffening but not weakening in age-matched subjects Dimitrios.

Thanos Sioris, MD, Tirone E

Designing valves: An art or science?

Descending thoracic and thoracoabdominal aortic aneurysms: “Busted”

Relationship of aortic cross-sectional area to height ratio and the risk of aortic dissection in patients with bicuspid aortic valves Lars G Svensson,

Paul Philipp Heinisch, MD, Thierry Carrel, MD

Presentation transcript:

Effect of aneurysm on the mechanical dissection properties of the human ascending thoracic aorta Salvatore Pasta, PhD, Julie A. Phillippi, PhD, Thomas G. Gleason, MD, David A. Vorp, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 143, Issue 2, Pages 460-467 (February 2012) DOI: 10.1016/j.jtcvs.2011.07.058 Copyright © 2012 Terms and Conditions

Figure 1 A, Photograph of representative specimen for delamination test showing through-thickness incision for creating initial dissection plane. B, Schematic experimental setup of delamination testing. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 460-467DOI: (10.1016/j.jtcvs.2011.07.058) Copyright © 2012 Terms and Conditions

Figure 2 Delamination profiles for A, three longitudinal (LONG) and B, three circumferential (CIRC) strips cut from same bicuspid aortic valve (BAV) aneurysm harvested from 56-year-old male patient with aortic diameter of 46 mm. Dashed lines represent average of mean values of peel tension (Tpeel) for all LONG and CIRC strips and taken as delamination strength (Sd) in LONG and CIRC directions for patient, respectively. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 460-467DOI: (10.1016/j.jtcvs.2011.07.058) Copyright © 2012 Terms and Conditions

Figure 3 A, Delamination strength in both longitudinal (LONG) (black squares) and circumferential (CIRC) (white squares) orientations. ∗Significantly different from LONG nonaneurysmal aorta (P < .05). ∗∗Significantly different from CIRC nonaneurysmal aorta (P < .05). †Significantly different from CIRC nonaneurysmal aorta (P < .05). B, Delamination strength of aneurysmal aorta with bicuspid aortic valve (BAVext, age) extrapolated (calculated) at age of each of patients with tricuspid aortic valve (TAV) in both LONG (black squares) and CIRC (white squares) directions for n = 8 specimens. ∗Significantly different from LONG nonaneurysmal aorta (P < .05). ∗∗Significantly different from CIRC nonaneurysmal aorta (P < .05). †Significantly different from CIRC nonaneurysmal aorta (P < .05). C, Delamination strength of aneurysmal aorta with BAV (BAVext, dia) extrapolated at aneurysm diameter of each patient with TAV in both LONG (black squares) and CIRC (white squares) directions for n = 8 specimens. ∗Significantly different from LONG aneurysmal aorta with BAVext (P < .05). ∗∗Significantly different from CIRC aneurysmal aorta with BAVext (P < .05). D, Tensile strength in LONG and E, CIRC directions for intimal surface and delaminated plane (INT-DEL) halves (black squares) and adventitial surface and delaminated plane (ADV-DEL) halves (white squares). ∗Significantly different from INT-DEL LONG BAV ascending thoracic aortic aneurysm (ATAA) (P < .001). ∗∗Significantly different from INT-DEL LONG BAV ATAA (P = .016). †Significantly different from INT-DEL CIRC TAV ATAA (P = .024). The Journal of Thoracic and Cardiovascular Surgery 2012 143, 460-467DOI: (10.1016/j.jtcvs.2011.07.058) Copyright © 2012 Terms and Conditions

Figure 4 A, Representative scanning electron microscope (SEM) images of fracture surfaces of nonaneurysmal and ascending thoracic aortic aneurysm (ATAA) with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in longitudinal (LONG) and circumferential (CIRC) direction. B, High magnification image of CIRC TAV ATAA for intimal surface and delaminated plane (INT-DEL) half showing bundles of broken elastin fibers (F) existing between elastic sheets (E). Fibers act as bridge between halves in fracture modality called “fiber bridging” in delamination testing. The Journal of Thoracic and Cardiovascular Surgery 2012 143, 460-467DOI: (10.1016/j.jtcvs.2011.07.058) Copyright © 2012 Terms and Conditions