Multidisciplinary Histological and Mechanical Study of Aortic Aneurysm to Investigate Potential Parameters for Early Diagnosis of High Risk Rupture Pasquale.

Slides:

Advertisements

Similar presentations

Allan Stewart, MD. , Jonathan A. Yang, MD; Mark J

Advertisements

In-Class Case Study: Determining the Mechanical Properties of Bone Using State-of-the-art Mechanical Testing System (MTS Bionix) Prepared by Prof. Deepak.

Università degli studi di Pavia Dipartimento di Ingegneria Civile e Architettura Corso di laurea in Bioingegneria Preoperative planning through CT data.

Ghanem et al., J Am Coll Cardiol 2010;55:1427–32..

MECHANICAL PROPERTIES

Forging new generations of engineers. The following MATERIAL PROPERTIES can be evaluated / determined by TENSILE TESTING: STRENGTH DUCTILITY ELASTICITY.

(1) Arch Debranching vs. Elephant Trunk for Hybrid Repair of the Proximal Thoracic Aorta Arch Debranching versus Elephant Trunk Procedures for Hybrid Repair.

MRI-Based Finite-Element Analysis of Left Ventricular Aneurysm Julius M. Guccione, Ph.D. Walker et al, Am J Physiol. 289:H , UCSF/VAMC Cardiac.

Antegrade Stent Grafting of Descending Thoracic Aorta During Acute Debakey I Dissection: Early and Midterm Outcomes Prashanth Vallabhajosyula MD, Joseph.

Conventional and frozen elephant trunk surgery for extensive aneurysmal disease of the thoracic aorta: a retrospective comparative study Marco Di Eusanio.

Aortic Root Conservative Repair in Acute Type A Aortic Dissection Involving Aortic Root: Fate of Aortic Root & Aortic Valve Function Joon Bum Kim, Su Kyung.

Systemic inflammatory response syndrome score at admission independently predicts mortality and length of stay in trauma patients. by R2 黃信豪.

D-dimer level remains a highly sensitive test for acute aortic dissection beyond the first 24 hours after onset AATS Aortic Symposium 2010 ▪ New York ▪

Presented to George Seweryniak Mathematical, Information, and Computational Sciences Erin A. Lennartz Virginia Polytechnic Institute and State University.

Design Automation Lab. – ND Biomechanics Group Cortical Bone Microstructure And Anisotropy Of Mechanical Properties Alejandro A. Espinoza Department of.

Use of Psoas Muscle Size as a Frailty Assessment Tool for Open and Transcatheter Aortic Valve Replacement Raghavendra Paknikar BS Jeffrey Friedman BS David.

Khalil Fattouch, Roberta Sampognaro, Giuseppe Speziale, Marco Caruso, Pietro Dioguardi, Salvatore Novo, Giovanni Ruvolo. Disclosures: None Disclosures:

A Propensity-matched Study of Lobectomy Versus Segmentectomy for Radiologically Pure Solid Small-sized Non-small Cell Lung Cancer Terumoto Koike 1, Seijiro.

Troubleshooting a Bending Device with Tissue and Non-Tissue Verification Laura Gump 1, Chad Eckert 2, Michael Sacks 2 1 Bioengineering & Bioinformatics.

In both humans and the rat, stiff conduit arteries are less able to buffer pulsatile changes in blood pressure, provoking CV and renal outcomes 1. Arterial.

Association between Systolic Blood Pressure and Congestive Heart Failure in Hypertensive Patients Mrs. Sutheera Intajarurnsan Doctor of Public Health Student.

The 70 gene Mammaprint ™ signature: a comparison with traditional clinico-pathological parameters. Patrizia Querzoli 1, Massimo Pedriali 1, Gardenia Munerato.

Impact of Concomitant Tricuspid Annuloplasty on Tricuspid Regurgitation Right Ventricular Function and Pulmonary Artery Hypertension After Degenerative.

Exercise Management Aneurysms Chapter 16. Exercise Management Pathophysiology Aneurysms can be caused by congenital or acquired diseases, are usually.

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

Matthew S. Slater, MD, Brian S. Diggs, PhD Frederick A. Tibayan, MD Steven G Guyton, MD, MPH Howard K. Song, MD, PhD The Department of Surgery, and the.

Echocardiographic predictors of perioperative atrial fibrillation EUROECHO 2010, Copenhagen, Denmark Katova T, Simova I, Nesheva A, Hristova K, Kostova.

Simultaneous Sessions: Congenital Heart Disease

Osaka University Department of Cardiovascular Surgery Osaka University Department of Cardiovascular Surgery The efficacy of debranching TEVAR for arch.

Parametric Study of Mechanical Stress in Abdominal Aortic Aneurysms (AAA) Erin A. Lennartz Virginia Polytechnic Institute and State University Research.

How I Would Like By Bicuspid Valve and Aneurysms Treated Thoralf M. Sundt,MD AATS Skills April 25,2015.

Strokes in Ascending Aortic Repairs: Predictive and Protective Factors Tovy Kamine, BS, Steven R Messé, MD, Elizabeth Leitner, Joseph Bavaria, MD, Michael.

SAFETY OF UNILATERAL Vs BILATERAL CEREBRAL PERFUSION DURING AORTIC SURGERY ASSESSED USING REGIONAL CEREBRAL OXYGEN SATURATION MONITORING IRCCS “Foundation.

AORTIC-LEFT VENTRICULAR TUNNEL. BASICS –CONNECTION BETWEEN AORTA AND LV, NOT INVOLVING THE AORTIC VALVE –USUALLY ARISE FROM R CORONARY SINUS, MOST COMMONLY.

Remodelling Ability of living tissue to adapt to its environment by changing its shape and structure Modifies mechanical properties Driven by tendency.

Finite Element Modelling of Intramural Haematoma in the Thoracic Aorta – size matters P Sastry 1, R. Aihong Zhao, M Field, D Richens.

Mechanical Properties of Materials

Aortic Surgery Symposium 2010 New York, NY April, 2010 Department of Cardiothoracic and Vascular Surgery The University of Texas Medical School at Houston.

PREDICTORS FOR IN HOSPITAL MORTALITY IN PATIENTS WITH TYPE A AORTIC DISSECTION FROM A TWO CENTRE EXPERIENCE S Leontyev, J Légaré, MA Borger, K Buth, AK.

S.Orsola Malpighi Hospital, Bologna

Osaka University Graduate School of Medicine Division of Cardiovascular Surgery Strategy of TEVAR for acute aortic dissection Osaka University Graduate.

Don’t Worry I am Ok! Goal of project GOAL OF PROJECT  TO AWARE ABOUT HEART DISEASES.  TO UNDERSTAND CAUSES OF HEART DISEASES.  TO AWARE PREVENTIVE.

Long-term Result of Acute Type B Aortic Dissection Department of Cardiovascular Surgery, Hyogo Brain and Heart Center at Himeji, Hyogo Brain and Heart.

CFD characterization and thrombogenicity analysis of a prototypal polymeric aortic valve Filippo Piatti 1, Matteo Selmi 1, Alessandra Pelosi 1, Thomas.

British Society of Cardiovascular Magnetic Resonance

Patients Characteristics

Bicuspid Aortic Valves

ME 7980 Cardiovascular Biofluid Mechanics

Contribution of Oxidized Low Density Lipoprotein and Nitric Oxide in the Pathogenesis of Early Onset Acute Myocardial Infarction in Egyptian population.

Date of download: 11/1/2017 Copyright © ASME. All rights reserved.

Multidisciplinary Histological and Mechanical Study of Aortic Aneurysm to Investigate Potential Parameters for Early Diagnosis of High Risk Rupture Pasquale.

Poisons Ratio Poisons ratio = . w0 w Usually poisons ratio ranges from

UOG Journal Club: July 2012 Maternal hemodynamics at 11–13 weeks’ gestation and risk of pre-eclampsia A. Khalil, R. Akolekar, A. Syngelaki, M. Elkhouli.

Tutorial in Mechanical Properties

Volume growth of abdominal aortic aneurysms correlates with baseline volume and increasing finite element analysis-derived rupture risk Moritz Lindquist.

Division of Cardiovascular Diseases No relevant author disclosures

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.

Indications for aortic replacement

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

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

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.

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,

Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks John A Elefteriades, MD The Annals of Thoracic.

Nicole M. Bhave et al. JIMG 2018;11:

Riccardo Codecasa, MD, Massimo A

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

Distribution of patient baseline characteristics among included studies. Distribution of patient baseline characteristics among included studies. Each.

A. Procopi, N. Procopi, JP Collet, O. Barthelemy, P. Leprince, R

Presentation transcript:

Multidisciplinary Histological and Mechanical Study of Aortic Aneurysm to Investigate Potential Parameters for Early Diagnosis of High Risk Rupture Pasquale Totaro MD,PhD Division of Cardiothoracic Surgery Center for Genetic Cardiovascular Pathology IRCCS Foundation Hospital “San Matteo”, PAVIA -Italy Computational Mechanics, Department of Engineering University of Pavia

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Background Optimization of decision making process in patients presenting with ascending aorta aneurysm is still debated

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Background Optimization of decision making process in patients presenting with ascending aorta aneurysm is still debated Despite several studies have been designed to evaluate potential predictive risk factors for early complications, maximum diameter still remains the key criteria for surgical indication

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Background

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Objective To investigate potential markers of early complication in patients presenting with aortic aneurysm we have analyzed the mechanical characteristics of aortic wall and we have tried to correlate these results to preoperative parameters and histological intraoperative evaluation

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Uniaxial Testing Device One or more test each Region/Orientation configuration Electromechanic Tension MTS Insight 10 kN (MTS System Corporation)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Circumferential Longitudinal 163 (66%) 71 (29%) 92 (37%) Circumferential Longitudinal 84 (34%) 32 (13%) 52 (21%) Overall Specimens: 403 Accepted Test: 247 (62%) Patients: 46 Samples:86 A1 A2 A3 P1 P2

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Pstr = Peek Stress (Mpa) EM = Maximum Elastic Modulus (Mpa) PS = Peek Strein (mm/min) 1. Preconditioning2. Failure Test Materials and Methods

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Age (> 60 yo) Gender Diameter (> 5cm) Indexed Diameter (>25) Bicuspid Valve Hypertension Aortic Insufficiency Preoperative Data Aortic Elasticity * Preoperative TTE Evaluation Aortic Distensibility (10 -6 cm 2 dyn -1 ) Aortic Stiffness Index Aortic Strein Histological Evaluation Elastolisis Mucoid Tissue Cystic Medionecrosis Disarrey Materials and Methods * Ikonomidis et al, JACC 2004 Pulse Pressure (dyne)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Age (> 60 yo) Gender Diameter (> 5cm) Indexed Diameter (>25) Bicuspid Valve Hypertension Aortic Insufficiency Preoperative Data Aortic Elasticity * Preoperative TTE Evaluation Aortic Distensibility (10 -6 cm 2 dyn -1 ) Aortic Stiffness Index Aortic Strein * Ikonomidis et al, JACC 2004 Histological Evaluation Elastolisis Mucoid Tissue Cystic Medionecrosis Disarrey Quantitative Score HATS (0-16) Materials and Methods Pulse Pressure (dyne)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Results – 1 (247 tests) p<0,0001 Pstr/Orientation EM/Orientation

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia p<0,0001 PS Pstr EM Impact of preoperative parameters: Age >60 Results – 1 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Results – 2 (247 tests) p<0, No significant differences

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia p<0, No significant differences Results – 2 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Age > 60 yo Gender Diameter > 5cm ID >25 Bicuspid Valve ? Preoperative Risk Factors Analysis Results – 2 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Age > 60 yo Gender Diameter > 5cm ID >25 Bicuspid Valve Preoperative Risk Factors Analysis P=0,027 Results – 2 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia p= NS (PL) p= NS (PC,PL) p= 0,001 (AC,AL) p= NS (PC,PL) p= 0,001 (AC,AL) p= 0,0001 (AC,AL,PC) Results – 2 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia p= 0,006 (AC) p= 0,003 (AC,PC) Correlation to TTE Aortic Elasticity Evaluation Results – 2 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia p=0,008 p=0,0047 Correlation to Histological Evaluation Results – 2 (247 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Results - 3

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Results – 3 (122 tests) P=0,02 (BV) P=0,04 (no BV)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia P=0,0056 (no BV) P=0,0112 (F) Correlation to TTE Aortic Elasticity Evaluation Results – 3 (122 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia P=0,0129 P=0,045 (BV) Correlation to Histological Evaluation Results – 3 (122 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia P=0,0019 Correlation to Histological Evaluation Results – 3 (122 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Results – 4 (52 tests) p=0,0034

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia p<0, p=0,0034 Results – 4 (52 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia P<0,0001 p<0, Results – 4 (52 tests)

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Conclusions - 1 Mechanical characteristics of aortic wall do vary according the region of the aorta and the force applied. Biomechanical characterization of aortic wall, therefore, has to be defined only with multiple tests from multiple specimens. Age is surely related to an impairment of mechanical properties The posterior region of the aorta seems to be more frail especially when a longitudinal force is applied regardless age of patients

AATS 2015 Seattle P.Totaro IRCCS San Matteo,Pavia-Italy University of Pavia Conclusions - 2 There are significant correlations between increased maximum diameter, histological abnormalities and reduced strength of aortic wall. These correlations, however, do vary according different regions of the aorta and the type of force applied. Presence of bicuspid valve does not seem to impact significantly the mechanical properties of aortic wall Preoperative evaluation of aortic elasticity may help to identify patients with impaired mechanical properties

Dad Come Back Home Please Thank You