The Experts below are selected from a list of 258 Experts worldwide ranked by ideXlab platform
Tobias Krüger - One of the best experts on this subject based on the ideXlab platform.
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aortic elongation in aortic aneurysm and dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P < 0.001) in the pre-TAD (43 mm) and TAD (56 mm) groups. The length of the ascending Aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P < 0.001 compared with the control group). An ascending Aorta length of 120 mm was exceeded in 2% of the control group, 31% of the ectasia group, 50% of the aneurysm group, 24% of the pre-TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending Aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia Aortas were elongated. CONCLUSIONS: Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending Aortas represent a high-risk subpopulation for TAD.
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Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P
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aortic elongation and the risk for dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2017Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, David Schibilsky, Mario Lescan, Katharina Bregel, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian BambergAbstract:OBJECTIVES: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). METHODS: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segments were recorded. Three groups were compared retrospectively: patients actually suffering from a TAD (TAD-group; n = 150), patients before suffering a TAD (preTAD-group n = 15) and a healthy control group ( n = 215). Receiver operating characteristic curves (ROCs) were analysed (control versus preTAD) to study the diagnostic value of the individual variables. RESULTS: Median diameters of preTAD (43 mm) and TAD (50 mm) Aortas were significantly ( P < 0.001) larger than those of the control group (35 mm). Ninety-three percent of preTAD and 68% of TAD Aortas were less than 55 mm in the mid-ascending Aorta. The ascending Aorta and the aortic arch were significantly longer in both preTAD and TAD Aortas compared to control Aortas ( P < 0.001); in the control Aortas the central line distance from the aortic valve to the brachiocephalic trunk was 93 mm. In preTAD Aortas, it was 111 mm, and it was 117 mm in TAD Aortas ( P < 0.001). In ROC analysis, the area under the curve was 0.912 for the ascending diameter and 0.787 for the ascending and arch lengths. CONCLUSIONS: TAD-prediction based on the aortic diameter is ineffective. Besides circumferential dilatation, ascending Aorta elongation precedes TAD and appears to be a useful additional parameter for prognostication. We propose a diagnostic score involving ascending Aorta diameter and length.
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Regional and Directional Compliance of the Aortic Wall: ex vivo Dynamic Testing and Implications for Aortic Pathophysiology
The Thoracic and Cardiovascular Surgeon, 2015Co-Authors: Tobias Krüger, Kujtim Veseli, D. Schibilsky, Hans Peter Wendel, H. Lausberg, W. Schneider, C SchlensakAbstract:Objective: To study the regional and directional compliance of the healthy Aorta in the porcine model and to develop a model of the pathophysiology of aortic dissection. Methods: We developed a custom made pulse duplicator capable perfusing complete Aortas ex vivo. Fresh porcine Aortas (n = 13) were perfused with defined hemodynamic parameters, aortic compliance was measured optically. Additionally tissue strips of Aortas were analyzed in a static tensile tester. Regional (ascendens, arch, descendens) and directional (transversal, longitudinal) compliance is studied under dynamic and static conditions. Results: The custom made pulse duplicator is capable perfusing the entire Aorta with eligible hemodynamic parameters (pressures, resistance and frequencies) and a physiologic pulse curve (30% systole and 70% diastole). Aortic compliance is pressure and stress dependent, under hypertensive conditions, above 200 mm Hg the porcine Aorta acts inelastic. Compliance of aortic tissue is highest in the ascending Aorta and significantly decreases in the course of the vessel. The longitudinal compliance in the ascending Aorta significantly exceeds the circumferential compliance, in the descending Aorta there are no relevant differences in directional compliance. Under dynamic conditions, the compliance of the outer curvature in the ascending Aorta significantly exceeds the compliance of the inner curvature. However, under static conditions, this effect is not verifiable. Conclusion: The new custom made pulse duplicator allows studying entire Aortas under dynamic and preferably realistic conditions ex vivo. Though dynamic compliance data are largely comparable to data generated using the classic method of static tensile testing, we also find some relevant differences between the methods, particularly regarding the regional compliance of the inner- and outer curvatures of the ascending Aorta. The longitudinal compliance of the ascending Aorta and especially of the outer curvature is predominantly responsible for the Windkessel effect. The three dimensional configuration of the ascending Aorta, its punctual fixation on the root and the supraaortic branches and its movement during the cardiac cycle determines regionally different mechanical stress and consecutive deformation of the aortic wall. Elongation and pronounced angulation of the ascending Aorta may increase the stress on the outer curvature and might be important factors in the development of aortic dissection.
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Elastic properties of the young Aorta: ex vivo perfusion experiments in a porcine model
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014Co-Authors: Tobias Krüger, Kujtim Veseli, Hans Peter Wendel, W. Schneider, David Schibilsky, Akvile Grigoraviciute, Christian SchlensakAbstract:OBJECTIVES: To investigate the regional and directional compliance/distensibility of the healthy Aorta. METHODS: Complete fresh porcine Aortas (n= 11) were perfused ex vivo under defined haemodynamic parameters using a custom-made pulse duplicator. Both circumferential and longitudinal compliance were measured optically. RESULTS: The pulse duplicator was able to perfuse the entire Aorta with arbitrary haemodynamic parameters, generating a physiological pulse curve. Aortic compliance is pressure dependent, as we observed a linear relationship between pressure and distension in the range of 5-200 mmHg; however, above 200 mmHg, the porcine Aorta behaved in an inelastic manner. Circumferential compliance was highest in the ascending Aorta (24%/100 mmHg) but significantly (P
Christian Schlensak - One of the best experts on this subject based on the ideXlab platform.
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aortic elongation in aortic aneurysm and dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P < 0.001) in the pre-TAD (43 mm) and TAD (56 mm) groups. The length of the ascending Aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P < 0.001 compared with the control group). An ascending Aorta length of 120 mm was exceeded in 2% of the control group, 31% of the ectasia group, 50% of the aneurysm group, 24% of the pre-TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending Aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia Aortas were elongated. CONCLUSIONS: Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending Aortas represent a high-risk subpopulation for TAD.
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Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P
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Elastic properties of the young Aorta: ex vivo perfusion experiments in a porcine model
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014Co-Authors: Tobias Krüger, Kujtim Veseli, Hans Peter Wendel, W. Schneider, David Schibilsky, Akvile Grigoraviciute, Christian SchlensakAbstract:OBJECTIVES: To investigate the regional and directional compliance/distensibility of the healthy Aorta. METHODS: Complete fresh porcine Aortas (n= 11) were perfused ex vivo under defined haemodynamic parameters using a custom-made pulse duplicator. Both circumferential and longitudinal compliance were measured optically. RESULTS: The pulse duplicator was able to perfuse the entire Aorta with arbitrary haemodynamic parameters, generating a physiological pulse curve. Aortic compliance is pressure dependent, as we observed a linear relationship between pressure and distension in the range of 5-200 mmHg; however, above 200 mmHg, the porcine Aorta behaved in an inelastic manner. Circumferential compliance was highest in the ascending Aorta (24%/100 mmHg) but significantly (P
Fabian Bamberg - One of the best experts on this subject based on the ideXlab platform.
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aortic elongation in aortic aneurysm and dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P < 0.001) in the pre-TAD (43 mm) and TAD (56 mm) groups. The length of the ascending Aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P < 0.001 compared with the control group). An ascending Aorta length of 120 mm was exceeded in 2% of the control group, 31% of the ectasia group, 50% of the aneurysm group, 24% of the pre-TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending Aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia Aortas were elongated. CONCLUSIONS: Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending Aortas represent a high-risk subpopulation for TAD.
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Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P
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aortic elongation and the risk for dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2017Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, David Schibilsky, Mario Lescan, Katharina Bregel, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian BambergAbstract:OBJECTIVES: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). METHODS: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segments were recorded. Three groups were compared retrospectively: patients actually suffering from a TAD (TAD-group; n = 150), patients before suffering a TAD (preTAD-group n = 15) and a healthy control group ( n = 215). Receiver operating characteristic curves (ROCs) were analysed (control versus preTAD) to study the diagnostic value of the individual variables. RESULTS: Median diameters of preTAD (43 mm) and TAD (50 mm) Aortas were significantly ( P < 0.001) larger than those of the control group (35 mm). Ninety-three percent of preTAD and 68% of TAD Aortas were less than 55 mm in the mid-ascending Aorta. The ascending Aorta and the aortic arch were significantly longer in both preTAD and TAD Aortas compared to control Aortas ( P < 0.001); in the control Aortas the central line distance from the aortic valve to the brachiocephalic trunk was 93 mm. In preTAD Aortas, it was 111 mm, and it was 117 mm in TAD Aortas ( P < 0.001). In ROC analysis, the area under the curve was 0.912 for the ascending diameter and 0.787 for the ascending and arch lengths. CONCLUSIONS: TAD-prediction based on the aortic diameter is ineffective. Besides circumferential dilatation, ascending Aorta elongation precedes TAD and appears to be a useful additional parameter for prognostication. We propose a diagnostic score involving ascending Aorta diameter and length.
W. Schneider - One of the best experts on this subject based on the ideXlab platform.
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aortic elongation in aortic aneurysm and dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P < 0.001) in the pre-TAD (43 mm) and TAD (56 mm) groups. The length of the ascending Aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P < 0.001 compared with the control group). An ascending Aorta length of 120 mm was exceeded in 2% of the control group, 31% of the ectasia group, 50% of the aneurysm group, 24% of the pre-TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending Aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia Aortas were elongated. CONCLUSIONS: Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending Aortas represent a high-risk subpopulation for TAD.
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Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P
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aortic elongation and the risk for dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2017Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, David Schibilsky, Mario Lescan, Katharina Bregel, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian BambergAbstract:OBJECTIVES: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). METHODS: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segments were recorded. Three groups were compared retrospectively: patients actually suffering from a TAD (TAD-group; n = 150), patients before suffering a TAD (preTAD-group n = 15) and a healthy control group ( n = 215). Receiver operating characteristic curves (ROCs) were analysed (control versus preTAD) to study the diagnostic value of the individual variables. RESULTS: Median diameters of preTAD (43 mm) and TAD (50 mm) Aortas were significantly ( P < 0.001) larger than those of the control group (35 mm). Ninety-three percent of preTAD and 68% of TAD Aortas were less than 55 mm in the mid-ascending Aorta. The ascending Aorta and the aortic arch were significantly longer in both preTAD and TAD Aortas compared to control Aortas ( P < 0.001); in the control Aortas the central line distance from the aortic valve to the brachiocephalic trunk was 93 mm. In preTAD Aortas, it was 111 mm, and it was 117 mm in TAD Aortas ( P < 0.001). In ROC analysis, the area under the curve was 0.912 for the ascending diameter and 0.787 for the ascending and arch lengths. CONCLUSIONS: TAD-prediction based on the aortic diameter is ineffective. Besides circumferential dilatation, ascending Aorta elongation precedes TAD and appears to be a useful additional parameter for prognostication. We propose a diagnostic score involving ascending Aorta diameter and length.
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Regional and Directional Compliance of the Aortic Wall: ex vivo Dynamic Testing and Implications for Aortic Pathophysiology
The Thoracic and Cardiovascular Surgeon, 2015Co-Authors: Tobias Krüger, Kujtim Veseli, D. Schibilsky, Hans Peter Wendel, H. Lausberg, W. Schneider, C SchlensakAbstract:Objective: To study the regional and directional compliance of the healthy Aorta in the porcine model and to develop a model of the pathophysiology of aortic dissection. Methods: We developed a custom made pulse duplicator capable perfusing complete Aortas ex vivo. Fresh porcine Aortas (n = 13) were perfused with defined hemodynamic parameters, aortic compliance was measured optically. Additionally tissue strips of Aortas were analyzed in a static tensile tester. Regional (ascendens, arch, descendens) and directional (transversal, longitudinal) compliance is studied under dynamic and static conditions. Results: The custom made pulse duplicator is capable perfusing the entire Aorta with eligible hemodynamic parameters (pressures, resistance and frequencies) and a physiologic pulse curve (30% systole and 70% diastole). Aortic compliance is pressure and stress dependent, under hypertensive conditions, above 200 mm Hg the porcine Aorta acts inelastic. Compliance of aortic tissue is highest in the ascending Aorta and significantly decreases in the course of the vessel. The longitudinal compliance in the ascending Aorta significantly exceeds the circumferential compliance, in the descending Aorta there are no relevant differences in directional compliance. Under dynamic conditions, the compliance of the outer curvature in the ascending Aorta significantly exceeds the compliance of the inner curvature. However, under static conditions, this effect is not verifiable. Conclusion: The new custom made pulse duplicator allows studying entire Aortas under dynamic and preferably realistic conditions ex vivo. Though dynamic compliance data are largely comparable to data generated using the classic method of static tensile testing, we also find some relevant differences between the methods, particularly regarding the regional compliance of the inner- and outer curvatures of the ascending Aorta. The longitudinal compliance of the ascending Aorta and especially of the outer curvature is predominantly responsible for the Windkessel effect. The three dimensional configuration of the ascending Aorta, its punctual fixation on the root and the supraaortic branches and its movement during the cardiac cycle determines regionally different mechanical stress and consecutive deformation of the aortic wall. Elongation and pronounced angulation of the ascending Aorta may increase the stress on the outer curvature and might be important factors in the development of aortic dissection.
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Elastic properties of the young Aorta: ex vivo perfusion experiments in a porcine model
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2014Co-Authors: Tobias Krüger, Kujtim Veseli, Hans Peter Wendel, W. Schneider, David Schibilsky, Akvile Grigoraviciute, Christian SchlensakAbstract:OBJECTIVES: To investigate the regional and directional compliance/distensibility of the healthy Aorta. METHODS: Complete fresh porcine Aortas (n= 11) were perfused ex vivo under defined haemodynamic parameters using a custom-made pulse duplicator. Both circumferential and longitudinal compliance were measured optically. RESULTS: The pulse duplicator was able to perfuse the entire Aorta with arbitrary haemodynamic parameters, generating a physiological pulse curve. Aortic compliance is pressure dependent, as we observed a linear relationship between pressure and distension in the range of 5-200 mmHg; however, above 200 mmHg, the porcine Aorta behaved in an inelastic manner. Circumferential compliance was highest in the ascending Aorta (24%/100 mmHg) but significantly (P
Alexandre Oikonomou - One of the best experts on this subject based on the ideXlab platform.
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aortic elongation in aortic aneurysm and dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P < 0.001) in the pre-TAD (43 mm) and TAD (56 mm) groups. The length of the ascending Aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P < 0.001 compared with the control group). An ascending Aorta length of 120 mm was exceeded in 2% of the control group, 31% of the ectasia group, 50% of the aneurysm group, 24% of the pre-TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending Aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia Aortas were elongated. CONCLUSIONS: Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending Aortas represent a high-risk subpopulation for TAD.
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Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.
European Journal of Cardio-Thoracic Surgery, 2018Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, Mario Lescan, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian Bamberg, Rodrigo Sandoval Boburg, Christian SchlensakAbstract:OBJECTIVES: To study the lengths and diameters of aortic segments in healthy and diseased Aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. METHODS: Ectasia and aneurysm were defined by ascending Aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD Aortas were analysed using curved multiplanar reformats. RESULTS: The study groups were structurally equal. The diameter of the ascending Aorta was 35 mm in the control group and was larger (P
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aortic elongation and the risk for dissection the tubingen aortic pathoanatomy taipan project
European Journal of Cardio-Thoracic Surgery, 2017Co-Authors: Tobias Krüger, W. Schneider, Alexandre Oikonomou, David Schibilsky, Mario Lescan, Katharina Bregel, Luise Vohringer, Henning F Lausberg, Gunnar Blumenstock, Fabian BambergAbstract:OBJECTIVES: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). METHODS: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segments were recorded. Three groups were compared retrospectively: patients actually suffering from a TAD (TAD-group; n = 150), patients before suffering a TAD (preTAD-group n = 15) and a healthy control group ( n = 215). Receiver operating characteristic curves (ROCs) were analysed (control versus preTAD) to study the diagnostic value of the individual variables. RESULTS: Median diameters of preTAD (43 mm) and TAD (50 mm) Aortas were significantly ( P < 0.001) larger than those of the control group (35 mm). Ninety-three percent of preTAD and 68% of TAD Aortas were less than 55 mm in the mid-ascending Aorta. The ascending Aorta and the aortic arch were significantly longer in both preTAD and TAD Aortas compared to control Aortas ( P < 0.001); in the control Aortas the central line distance from the aortic valve to the brachiocephalic trunk was 93 mm. In preTAD Aortas, it was 111 mm, and it was 117 mm in TAD Aortas ( P < 0.001). In ROC analysis, the area under the curve was 0.912 for the ascending diameter and 0.787 for the ascending and arch lengths. CONCLUSIONS: TAD-prediction based on the aortic diameter is ineffective. Besides circumferential dilatation, ascending Aorta elongation precedes TAD and appears to be a useful additional parameter for prognostication. We propose a diagnostic score involving ascending Aorta diameter and length.
