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Role of aortic root motion in the pathogenesis of aortic dissection
Carsten J Beller1, Michel R Labrosse, Mano J Thubrikar
1Clinic for Cardiothoracic Surgery, Heart Institute Lahr/Baden, Germany.
Circulation
|February 19, 2004
Summary
Aortic root movement and high blood pressure significantly raise stress in the ascending aorta. Monitoring aortic root displacement is crucial for hypertension patients at risk of aortic dissection.
Area of Science:
- Cardiovascular Mechanics
- Biomedical Engineering
- Medical Imaging
Background:
- Downward movement of the aortic root during the cardiac cycle is a potential cause of tears in aortic dissections.
- Understanding the biomechanics of the aortic root is critical for diagnosing and managing aortic dissections.
Purpose of the Study:
- To assess the influence of aortic root displacement and pressure on aortic wall stress using a finite element model.
- To investigate the relationship between aortic root movement, hypertension, and the risk of aortic dissection.
Main Methods:
- Contrast injections were performed in 40 cardiac patients.
- A finite element model of the aortic root, arch, and branches was developed.
- Aortic root axial displacement was measured and correlated with patient conditions like aortic insufficiency and left ventricular hypokinesis.
Main Results:
- Aortic root axial displacement ranged from 0 to 14 mm, varying with conditions such as aortic insufficiency and left ventricular hypokinesis.
- The greatest increase in longitudinal stress (50%) occurred approximately 2 cm above the sino-tubular junction with 8.9-mm axial displacement and 120-mm Hg pressure.
- Increased luminal pressure to 180 mm Hg without axial displacement yielded similar stress increases.
Conclusions:
- Both aortic root displacement and hypertension significantly elevate longitudinal stress in the ascending aorta.
- Aortic root movement should be monitored as a key risk factor in hypertensive patients susceptible to aortic dissection.
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