The Influence of Aortic Wall Elasticity on the False Lumen in Aortic Dissection: An In Vitro Study

Abstract

<jats:sec><jats:title>Background:</jats:title><jats:p> Hemodynamics, dissection morphology, and aortic wall elasticity have a major influence on the pressure in the false lumen. In contrast to aortic wall elasticity, the influence of hemodynamics and dissection morphology have been investigated often in multiple in vitro and ex vivo studies. The purpose of this study was to evaluate the influence of aortic wall elasticity on the diameter and pressure of the false lumen in aortic dissection. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> An artificial dissection was created in 3 ex vivo porcine aortas. The aorta models were consecutively positioned in a validated in vitro circulatory system with physiological pulsatile flow. Each model was imaged with ultrasound on 4 positions along the aorta and the dissection. At these 4 locations, pressure measurement was also performed in the true and false lumen with an arterial catheter. After baseline experiments, the aortic wall elasticity was adjusted with silicon and the experiments were repeated. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The aortic wall elasticity was decreased in all 3 models after siliconizing. In all 3 siliconized models, the diameters of the true and false lumen increased at proximal, mid, and distal location, while the mean arterial pressure did not significantly change. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> In this in vitro study, we showed that aortic wall elasticity is an important parameter altering the false lumen. An aortic wall with reduced elasticity results in an increased false lumen diameter in the mid and distal part of the false lumen. These results can only be transferred to corresponding clinical situations to a limited extent. </jats:p></jats:sec>

False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection

“…Such pressure variations are unphysiological. A recent ex vivo study in porcine aorta showed an aortic wall with reduced elasticity results in an increased FL diameter [ 24 ]. However, inclusion of elasticity as a study variable requires a fluid–structure interaction simulation model.…”