Role of regional aortic wall properties in the pathogenesis of thoracic aortic dissection.

Abstract

OBJECTIVES The mechanisms of the location and extension of acute aortic dissection (AD) are only poorly understood. The aim of this study was to compare the cohesion of the non-coronary aortic sinus (NAS) and the ascending aortic wall (AA) using the Dissectometer - a new device for analyses of the mechanical properties of the aorta. DESIGN The properties of the aortic wall were analyzed with the "Dissectometer" (parameters P7, P8 and P9) in adult patients undergoing aortic root (AR) replacement in two different segments: NAS and AA. The aortic wall thickness (AWT) was measured with a micrometer. RESULTS Thirty-three adult patients (mean age 65 ± 14 years, 80% male) were included in this study. The aortic wall of the NAS was significantly thinner than that of the AA (1.9 ± 0.4 vs. 2.3 ± 0.4, p < 0.01). In contrast, mechanical stability assessed by cohesion testing was diminished in AA samples compared to NAS samples (P7: 86.0 ± 55.0 vs. 152.3 ± 89.2, p < 0.01; P8: 2.5 ± 1.3 vs. 6.0 ± 3.1, p < 0.01; P9: 3.6 ± 1.4 vs. 7.8 ± 3.2, p < 0.01). CONCLUSIONS This study shows that the wall of the AR is characterized by a thin but stable wall, whereas AA was found to be weaker despite its greater thickness. This difference might be involved in the development and spreading of aortic dissections.

DOI: 10.1080/14017431.2016.1210211

Cite this paper

@article{Himpel2017RoleOR, title={Role of regional aortic wall properties in the pathogenesis of thoracic aortic dissection.}, author={Lisa Himpel and Kevin Pilarczyk and Aziz Wahbi and Fanar Mourad and Konstantinos Tsagakis and Heinz G{\"{u}nther Jakob and Jaroslav Bened{\'i}k}, journal={Scandinavian cardiovascular journal : SCJ}, year={2017}, volume={51 1}, pages={35-39} }