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A novel insight into the role of entry tears in type B aortic dissection: pressure measurements in an in vitro model

Abstract

Introduction

Predicting aortic growth in acute type B dissection is fundamental in planning interventions. Several factors are considered to be growth predictors in the literature and, among them, size and location of entry tears have been recognized to particularly influence the false lumen pressure. In this study, we develop an in vitro setting to analyze the actual impact of size and location of the entry tears on false lumen pressure, in the absence of other confounding factors such as the deformability of the aortic wall.

Methods

We formalize some indexes that synthetically describe the false lumen pressure with respect to the true lumen pressure. Then, we experimentally derive their values in several configurations of the in vitro setting, and we look for trends in the indexes with respect to the size and location of entry tears.

Results

Results show that the tears have a relevant impact on the false lumen pressure, but that their size and location alone are not enough to explain the phenomena observed in vivo.

Conclusions

To predict the behavior of acute type B dissection, we therefore recommend not limiting to size and location, as many effects may derive from the interactions between these parameters and other patient characteristics.

Int J Artif Organs 2017; 40(10): 563 - 574

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ijao.5000627

Authors

Stefania Marconi, Ettore Lanzarone, Hector De Beaufort, Michele Conti, Santi Trimarchi, Ferdinando Auricchio

Article History

Disclosures

Financial support: This study falls under the framework of the 3D@UniPV project (www.unipv.it/3d), one of the strategic research areas of the University of Pavia. The work was supported by: the Flagship Project Factory of the Future (Projects Fab@Hospital and F@H for 3D plates) funded by the Italian MIUR and CNR organizations; the European Research Council through the ERC Starting Grant ISOBIO: Isogeometric Methods for Biomechanics (No. 259229); the iCardioCloud project funded by Cariplo Foundation (No. 2013-1779) and Lombardy Region (No. 42938382; No. 46554874); the Pancreatic ductal adenocarcinoma project, funded by the Italian Minister of Health (PE - 2013-02358887).
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Department of Civil Engineering and Architecture, University of Pavia, Pavia - Italy
  • National Research Council of Italy - Institute for Applied Mathematics and Information Technologies (CNR-IMATI), Milan - Italy
  • IRCCS Policlinico San Donato, San Donato Milanese, Milan - Italy

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