4.6 Article Proceedings Paper

Elastic properties of the young aorta: ex vivo perfusion experiments in a porcine model

Journal

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
Volume 48, Issue 2, Pages 221-227

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/ejcts/ezu438

Keywords

Aorta; Aortic compliance; Aortic dissection

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OBJECTIVES: To investigate the regional and directional compliance/distensibility of the healthy aorta. METHODS: Complete fresh porcine aortas (n = 11) were perfused ex vivo under defined haemodynamic parameters using a custom-made pulse duplicator. Both circumferential and longitudinal compliance were measured optically. RESULTS: The pulse duplicator was able to perfuse the entire aorta with arbitrary haemodynamic parameters, generating a physiological pulse curve. Aortic compliance is pressure dependent, as we observed a linear relationship between pressure and distension in the range of 5-200 mmHg; however, above 200 mmHg, the porcine aorta behaved in an inelastic manner. Circumferential compliance was highest in the ascending aorta (24%/ 100 mmHg) but significantly (P < 0.05) decreased in both the arch (18%/ 100 mmHg) and the descending aorta (15%/100 mmHg). Longitudinal compliance was highest in the ascending aorta and clearly exceeded circumferential compliance. Compliance was significantly (P < 0.05) higher in the outer curvatures of the ascending aorta and the aortic arch compared with the compliance of the inner curvature at these locations (30%/100 vs 23%/100 mmHg in the ascending aorta and 20%/ 100 vs 9%/100 mmHg in the arch, respectively). CONCLUSIONS: Longitudinal compliance of the ascending aorta, particularly the outer curvature, is predominantly responsible for the 'Windkessel effect'. Pathological changes such as elongation and pronounced angulation of the ascending aorta increase stress on the outer curvature and may be important factors in the development of aortic dissection.

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