Type A aortic dissection model to improve endovascular research and technologies

Area of Science:

• Cardiovascular Surgery
• Medical Device Technology
• Anatomical Modeling

Background:

• Type A aortic dissection is a critical condition necessitating immediate surgical intervention.
• Endovascular stent-graft implantation is a standard procedure for aneurysms and dissections, but challenging in the ascending aorta.

Purpose of the Study:

• To develop and validate a reproducible model of ascending aortic dissection.
• To simulate endovascular treatment for ascending aortic dissections.

Main Methods:

• A semicircular incision was made in the ascending aorta of five human aortas to separate the medial and intimal layers.
• The intimal tube was reapproximated with sutures, and the model was assessed using computed tomography.
• Thoracic endovascular aortic repair was simulated by implanting a bare-metal stent in four models.

Main Results:

• Computed tomography confirmed clear visualization of the dissection membrane in all prepared aortas.
• The intimal flap to aortic wall distance decreased from 0.63 cm to 0.26 cm after stent implantation.
• The dissection was located 3.9 cm from the aortic annulus and measured 4.6 cm in length.

Conclusions:

• The developed ascending aortic dissection model is reproducible and accurately reflects pathological and morphological features.
• This model serves as a valuable tool for assessing novel stent-graft technologies for type A dissection.
• The technique facilitates surgical training for endovascular repair of ascending aortic dissections.