Objective: The relationship among increased aortic arch angulation, aortic fl ow dynamics, and vessel wall stiffness remains unclear. This experimental ex vivo study investigated how increased aortic arch angulation affects aortic stiffness and stent-graft induced aortic stiffening, assessed by pulse wave velocity (PWV). Methods: Porcine thoracic aortas were connected to a circulatory mock loop in a Type I and Type III aortic arch configuration. fi guration. Baseline characteristics and blood pressures were measured. Proximal and distal fl ow curves were acquired to calculate PWV in both arch configurations. fi gurations. After that, a thoracic stent-graft (VAMF2626C100TU) was deployed in aortas with adequate proximal landing zone diameters to reach 10% % t0 20% % oversizing. Acquisitions were repeated for both arch configurations fi gurations after stent-graft deployment. Results: Twenty-four aortas were harvested, surgically prepared, and mounted. Cardiac output was kept constant for both arch configurations fi gurations (Type I: 4.74 +/- 0.40 and Type III: 4.72 +/- 0.38 L/minute; P = .703). Compared with a Type I arch, aortic PWV increased significantly fi cantly in the Type III arch (3.53 +/- 0.40 vs 3.83 +/- 0.40 m/second; P < .001), as well as blood pressures. A stent-graft was deployed in 15 aortas. After deployment, Type I arch PWV increased (3.55 +/- 0.39 vs 3.81 +/- 0.44 m/second; P < .001) and Type III arch PWV increased although not significantly fi cantly (3.86 +/- 0.42 vs 4.03 +/- 0.46 m/second; P = .094). Type III arch PWV resulted the highest and significantly fi cantly higher compared with the Type I arch after stent-graft deployment (3.81 +/- 0.44 vs 4.03 +/- 0.46 m/second; P = .023). Conclusions: Increased aortic arch angulation-as - as in a Type III arch-is - is associated with higher aortic PWV and blood pressures and this may negatively influence fl uence cardiovascular health. (JTCVS Open 2024;17:37-46)
Type III aortic arch angulation increases aortic stiffness: Analysis from an ex vivo porcine model
Pascaner, Ariel F.;Conti, Michele;Schembri, Martina;Auricchio, Ferdinando;
2024-01-01
Abstract
Objective: The relationship among increased aortic arch angulation, aortic fl ow dynamics, and vessel wall stiffness remains unclear. This experimental ex vivo study investigated how increased aortic arch angulation affects aortic stiffness and stent-graft induced aortic stiffening, assessed by pulse wave velocity (PWV). Methods: Porcine thoracic aortas were connected to a circulatory mock loop in a Type I and Type III aortic arch configuration. fi guration. Baseline characteristics and blood pressures were measured. Proximal and distal fl ow curves were acquired to calculate PWV in both arch configurations. fi gurations. After that, a thoracic stent-graft (VAMF2626C100TU) was deployed in aortas with adequate proximal landing zone diameters to reach 10% % t0 20% % oversizing. Acquisitions were repeated for both arch configurations fi gurations after stent-graft deployment. Results: Twenty-four aortas were harvested, surgically prepared, and mounted. Cardiac output was kept constant for both arch configurations fi gurations (Type I: 4.74 +/- 0.40 and Type III: 4.72 +/- 0.38 L/minute; P = .703). Compared with a Type I arch, aortic PWV increased significantly fi cantly in the Type III arch (3.53 +/- 0.40 vs 3.83 +/- 0.40 m/second; P < .001), as well as blood pressures. A stent-graft was deployed in 15 aortas. After deployment, Type I arch PWV increased (3.55 +/- 0.39 vs 3.81 +/- 0.44 m/second; P < .001) and Type III arch PWV increased although not significantly fi cantly (3.86 +/- 0.42 vs 4.03 +/- 0.46 m/second; P = .094). Type III arch PWV resulted the highest and significantly fi cantly higher compared with the Type I arch after stent-graft deployment (3.81 +/- 0.44 vs 4.03 +/- 0.46 m/second; P = .023). Conclusions: Increased aortic arch angulation-as - as in a Type III arch-is - is associated with higher aortic PWV and blood pressures and this may negatively influence fl uence cardiovascular health. (JTCVS Open 2024;17:37-46)I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
