Multiaxial pulsatile dynamics of the thoracic aorta and impact of thoracic endovascular repair
Journal article, 2021

Purpose:
The thoracic aorta is a highly mobile organ whose dynamics are altered by thoracic endovascular aorta repair (TEVAR). The aim of this study was to quantify cardiac pulsatility-induced multi-axial deformation of the thoracic aorta before and after descending aortic TEVAR.
Methods:
Eleven TEVAR patients (8 males and 3 females, age 57–89) underwent retrospective cardiac-gated CT angiography before and after TEVAR. 3D geometric models of the thoracic aorta were constructed, and lumen centerlines, inner and outer surface curves, and cross-sections were extracted to measure aortic arclength, centerline, inner surface, and outer surface longitudinal curvatures, as well as cross-sectional effective diameter and eccentricity for the ascending and stented aortic portions.
Results:
From pre- to post-TEVAR, arclength deformation was increased at the ascending aorta from 5.9 ± 3.1 % to 8.8 ± 4.4 % (P < 0.05), and decreased at the stented aorta from 7.5 ± 5.1 % to 2.7 ± 2.5 % (P < 0.05). Longitudinal curvature and diametric deformations were reduced at the stented aorta. Centerline curvature, inner surface curvature, and cross-sectional eccentricity deformations were increased at the distal ascending aorta.
Conclusions:
Deformations were reduced in the stented thoracic aorta after TEVAR, but increased in the ascending aorta near the aortic arch, possibly as a compensatory mechanism to maintain overall thoracic compliance in the presence of reduced deformation in the stiffened stented aorta.

Deformation

Aortic dissection

Cardiac pulsatility

Aortic aneurysm

Thoracic aorta

TEVAR

Author

Ga Young Suh

Stanford University

The California State University

Johan Bondesson

Chalmers, Mechanics and Maritime Sciences (M2), Dynamics

Yufei D. Zhu

Stanford University

Jason T. Lee

Stanford University

Michael D. Dake

Stanford University

Christopher Cheng

Stanford University

European Journal of Radiology Open

2352-0477 (eISSN)

Vol. 8 100333

Subject Categories

Wood Science

Surgery

Cardiac and Cardiovascular Systems

DOI

10.1016/j.ejro.2021.100333

PubMed

33748348

More information

Latest update

7/28/2021