Dissection properties of the human aortic media: an experimental study

Aortic dissection occurs frequently and is clinically challenging; the underlying mechanics remain unclear. The present study investigates the dissection properties of the media of 15 human abdominal aortas (AAs) by means of direct tension tests (n=8) and peeling tests (n=12). The direct tension test demonstrates the strength of the media in the radial direction, while the peeling test allows a steady-state investigation of the dissection propagation. To explore the development of irreversible microscopic changes during medial dissection, histological images (n=8) from four AAs at different peeling stages are prepared and analyzed. Direct tension tests of coin-shaped medial specimens result in a radial failure stress of 140.1+/-15.9 kPa (mean+/-SD, n=8). Peeling tests of rectangular-shaped medial strips along the circumferential and axial directions provide peeling force/width ratios of 22.9+/-2.9 mN/mm (n=5) and 34.8+/-15.5 mN/mm (n=7); the related dissection energies per reference area are 5.1+/-0.6 mJ/cm(2) and 7.6+/-2.7 mJ/cm(2), respectively. Although student's t-tests indicate that force/width values of both experimental tests are not significantly different (alpha=0.05, p=0.125), the strikingly higher resisting force/width obtained for the axial peeling tests is perhaps indicative of anisotropic dissection properties of the human aortic media. Peeling in the axial direction of the aorta generates a remarkably "rougher" dissection surface with respect to the surface generated by peeling in the circumferential direction. Histological analysis of the stressed specimens reveals that tissue damage spreads over approximately six to seven elastic laminae, which is about 15-18% of the thickness of the abdominal aortic media, which forms a pronounced cohesive zone at the dissection front.