Aortic Root Biomechanics After Sleeve and David Sparing Techniques: A Finite Element Analysis

التفاصيل البيبلوغرافية
العنوان: Aortic Root Biomechanics After Sleeve and David Sparing Techniques: A Finite Element Analysis
المؤلفون: Amando Gamba, Emiliano Votta, Francesco Sturla, Alberto Redaelli, Paola Redaelli, Matteo Selmi, Giordano Tasca
المصدر: The Annals of thoracic surgery. 103(5)
سنة النشر: 2016
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Aortic root, Finite Element Analysis, Aorta, Thoracic, 030204 cardiovascular system & hematology, Aortic root aneurysm, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Computer Simulation, Surgical repair, Aortic Aneurysm, Thoracic, business.industry, Biomechanics, Models, Cardiovascular, Surgery, Cardiology and Cardiovascular Medicine, Anatomy, Sinus of Valsalva, Finite element method, Biomechanical Phenomena, medicine.anatomical_structure, 030228 respiratory system, Nonlinear Dynamics, Time course, cardiovascular system, business
الوصف: Background Aortic root aneurysm can be treated with valve-sparing procedures. The David and Yacoub techniques have shown excellent long-term results but are technically demanding. Recently, a new and simpler procedure, the Sleeve technique, was proposed with encouraging results. We aimed to quantify the biomechanics of the initially aneurysmal aortic root (AR) after the Sleeve procedure to assess whether it induces abnormal stresses, potentially undermining its durability. Methods Two finite element (FE) models of the physiologic and aneurysmal AR were built, accounting for the anatomical asymmetry and the nonlinear and anisotropic mechanical properties of human AR tissues. On the aneurysmal model, the Sleeve and David techniques were simulated based on the corresponding published technical features. Aortic root biomechanics throughout 2 consecutive cardiac cycles were computed in each simulated configuration. Results Both sparing techniques restored physiologic-like kinematics of aortic valve (AV) leaflets but induced different leaflets stresses. The time course averaged over the leaflets' bellies was 35% higher in the David model than in the Sleeve model. Commissural stresses, which were equal to 153 and 318 kPa in the physiologic and aneurysmal models, respectively, became 369 and 208 kPa in the David and Sleeve models, respectively. Conclusions No intrinsic structural problems were detected in the Sleeve model that might jeopardize the durability of the procedure. If corroborated by long-term clinical outcomes, the results obtained suggest that using this new technique could successfully simplify the surgical repair of AR aneurysms and reduce intraoperative complications.
تدمد: 1552-6259
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6be6f52ff627d8d756154eb303736eea
https://pubmed.ncbi.nlm.nih.gov/29455808
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....6be6f52ff627d8d756154eb303736eea
قاعدة البيانات: OpenAIRE