Current assessment and management of ascending thoracic aortic aneurysm (ATAA) rely heavily on the diameter of the ATAA and blood pressure rather than biomechanical and hemodynamic parameters such as arterial wall deformation or wall shear stress. The objective of the current study was to develop an accurate computational method for modeling the mechanical responses of the ATAA to provide additional information in patient evaluations. Fully coupled fluid structure interaction simulations were conducted using data from cases with ATAA with measured geometrical parameters in order to evaluate and analyze the change in biomechanical responses under normotensive and hypertensive conditions. Anisotropic hyperelastic material property estimates were applied to the ATAA data which represented three different geometrical configurations of ATAAs. The resulting analysis showed significant variations in maximum wall shear stress despite minimal differences in flow velocity between two blood pressure conditions. Additionally, the three different ATAA conditions identified different aortic expansions that were not uniform under pulsatile pressure. The elevated wall stress with hypertension was also geometry-dependent. The developed models suggest that ATTA cases have unique characteristic in biomechanical and hemodynamic evaluations that can be useful in risk management.
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http://dx.doi.org/10.1007/s11517-017-1693-z | DOI Listing |
Eur J Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Division of Heart and Lung Disease, Utrecht University Medical Center, Utrecht, The Netherlands.
Objective: Aortic valve repair/sparing have been established as effective treatments for aortic regurgitation and/or aortic aneurysms. However, concerns remain regarding long-term durability, reproducibility, and patient selection. This study aims to asses long-term clinical and echocardiographic outcomes, with a focus on aortic regurgitation grade and left ventricular ejection fraction evolution, in adults undergoing these procedures.
View Article and Find Full Text PDFJ Forensic Leg Med
January 2025
Department of Diagnostics and Public Health, Section of Forensic Medicine, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy.
Thoracic aortic aneurysms are considered more dangerous than abdominal aneurysms because they are often silent until rupture and, therefore, are more challenging to diagnose and have a high mortality rate. In addition, a thoracic aneurysm differs from an abdominal one in terms of causes and risk factors: the former is associated with the degeneration of the vessel's middle tunica, while the latter is related to atherosclerosis. We report the case of the sudden death of a 20-year-old man, with no apparent risk factors and suffering only from a persistent cough for a month, in whom the autopsy revealed the rupture of a massive aneurysm of the ascending thoracic aorta.
View Article and Find Full Text PDFAnn Thorac Surg
January 2025
Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Philadelphia, PA.
Background: This study describes in detail the clinical burden of malperfusion associated with acute Type A aortic dissection (ATAAD) in a large, national cohort and the effect of treatment strategy on outcomes.
Methods: All patients undergoing repair of ATAAD between 2017 and 2020 in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database were studied. Malperfusion was defined using STS definitions based on imaging or surgeon's evaluation.
Forensic Sci Med Pathol
January 2025
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, Naples, 80131, Italy.
The dissection of the aorta is a serious and potentially fatal consequence of cocaine use. Nonetheless, the underlying mechanisms and characteristics of this phenomenon remain to be deeply studied. The autopsy case of a 46-year-old white male found irresponsive and unconscious in his house and had a history of abusing cocaine is presented.
View Article and Find Full Text PDFTher Adv Cardiovasc Dis
January 2025
Department of Cardiac Surgery, LMU University Hospital, Ludwig Maximilian University, Munich, Germany.
Background: Extensive surgical resection of the thoracic aorta in patients with type A aortic dissection (TAAD) is thought to reduce the risk of late aortic wall degeneration and the need for repeat aortic operations.
Objectives: We evaluated the early and late outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root.
Design: Retrospective, multicenter cohort study.
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