Inelastic vascular prosthesis for proximal aorta increases pulsatile arterial load and causes left ventricular hypertrophy in dogs Shigeki Morita, MDa,

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Inelastic vascular prosthesis for proximal aorta increases pulsatile arterial load and causes left ventricular hypertrophy in dogs Shigeki Morita, MDa, Toshihide Asou, MDa, Izumi Kuboyama, MDa, Yasuhiko Harasawa, MDb, Kenji Sunagawa, MDb, Hisataka Yasui, MDa The Journal of Thoracic and Cardiovascular Surgery Volume 124, Issue 4, Pages 768-774 (October 2002) DOI: 10.1067/mtc.2002.124244 Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Surgical preparations are shown for the dogs with bypass (left panel) and control (right panel). The bypass was constructed from the ascending aorta to the abdominal aorta. The aortic arch was occluded with an implantable aortic clamp between the brachiocephalic artery and the left subclavian artery in the bypass group. The blood flowed through the bypass graft and retrogradely flowed into the descending thoracic aorta and to the left subclavian artery (left panel). In the control group, the same operation was performed as in the bypass group except for not occluding the aortic arch and the bypass graft being suture ligated at the both ends so that the blood flowed normally (right panel). The Journal of Thoracic and Cardiovascular Surgery 2002 124, 768-774DOI: (10.1067/mtc.2002.124244) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Representative time domain pressure and flow tracings are shown. Since the flow tracings are obtained by velocity sensor and were calibrated later with cardiac output obtained by thermodilution catheter, the scale and unit of the flow signals are not shown in the figure. AOP, Aortic pressure; LVP, left ventricular pressure; LVEDP, left ventricular end-diastolic pressure. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 768-774DOI: (10.1067/mtc.2002.124244) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Representative aortic input impedance spectra of a control dog (left panel) and a dog with a bypass (right panel) are shown. In the control dog, the first minima appeared at about 4 Hz. In a dogs with bypass the first minima was at 2 Hz and it was followed by large maxima, which was seen at 4 Hz. Impedance was persistently elevated at higher frequency range. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 768-774DOI: (10.1067/mtc.2002.124244) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Comparison of resistance (left panel), arterial compliance (middle panel), and characteristic impedance (right panel) between the control and bypass group. Characteristic impedance was significantly higher in the dogs with bypass, whereas no significant differences in resistance and compliance were observed between the 2 groups. The Journal of Thoracic and Cardiovascular Surgery 2002 124, 768-774DOI: (10.1067/mtc.2002.124244) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions