scholarly journals Aortic Blunt Trauma Analysis during a Frontal Impact

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Mario Alberto Grave-Capistrán ◽  
Arturo Yishai Prieto-Vázquez ◽  
Christopher René Torres-SanMiguel
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Severity Index ◽  
Biological Properties ◽  
Original Position ◽  
Medical Attention ◽  
Artery Wall ◽  
Three Dimensional Model ◽  
Descending Aorta ◽  
Compression Load

The aorta is the largest artery of the human body, and it is considered in the continuous medium mechanics as a hyperelastic material for its biological properties. The thoracic aorta is directly affected in vehicular collision events by compression generated between the ribcage and the three-point seatbelt tension producing injuries in the artery wall. A three-dimensional model of the thoracic aorta was constructed from digital tomographic images considering the ascending aorta, the aortic arch, and the descending aorta. The model obtained presents acceptable characteristics such as a length of 222.8 mm and an ascending aortic diameter of 22.7 mm, 22.7 mm in the aortic arch, and 16.09 mm in the descending aorta. A 150 ms time numerical simulation was developed through the finite element method (MEF), and the model was analyzed simulating a compression load on the artery at its front location. Boundary conditions were considered by selecting specific nodes in the model, such as the points where the artery is held in the thorax with other elements. In addition, displacement nodes were considered to establish a natural behavior of the artery. The outcomes show significant displacements in the artery wall. The most affected areas are the aortic arch and descending aorta, whose displacements reach 14 mm from their original position. Based on the abbreviated injury scale (AIS), the degree of injury to the aorta in this collision event is estimated, an AIS 2 with a moderate severity index and required medical attention.

Dilatation of the entire thoracic aorta in patients with bicuspid aortic valve: a magnetic resonance angiography study

VASA ◽  
2005 ◽  
Vol 34 (3) ◽  
pp. 181-185 ◽  
Author(s):  
Westhoff-Bleck ◽  
Meyer ◽  
Lotz ◽  
Tutarel ◽  
Weiss ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Severe Aortic Regurgitation

Background: The presence of a bicuspid aortic valve (BAV) might be associated with a progressive dilatation of the aortic root and ascending aorta. However, involvement of the aortic arch and descending aorta has not yet been elucidated. Patients and methods: Magnetic resonance angiography (MRA) was used to assess the diameter of the ascending aorta, aortic arch, and descending aorta in 28 patients with bicuspid aortic valves (mean age 30 ± 9 years). Results: Patients with BAV, but without significant aortic stenosis or regurgitation (n = 10, mean age 27 ± 8 years, n.s. versus control) were compared with controls (n = 13, mean age 33 ± 10 years). In the BAV-patients, aortic root diameter was 35.1 ± 4.9 mm versus 28.9 ± 4.8 mm in the control group (p < 0.01). The diameter of the ascending aorta was also significantly increased at the level of the pulmonary artery (35.5 ± 5.6 mm versus 27.0 ± 4.8 mm, p < 0.001). BAV-patients with moderate or severe aortic regurgitation (n = 18, mean age 32 ± 9 years, n.s. versus control) had a significant dilatation of the aortic root, ascending aorta at the level of the pulmonary artery (41.7 ± 4.8 mm versus 27.0 ± 4.8 mm in control patients, p < 0.001) and, furthermore, significantly increased diameters of the aortic arch (27.1 ± 5.6 mm versus 21.5 ± 1.8 mm, p < 0.01) and descending aorta (21.8 ± 5.6 mm versus 17.0 ± 5.6 mm, p < 0.01). Conclusions: The whole thoracic aorta is abnormally dilated in patients with BAV, particularly in patients with moderate/severe aortic regurgitation. The maximum dilatation occurs in the ascending aorta at the level of the pulmonary artery. Thus, we suggest evaluation of the entire thoracic aorta in patients with BAV.

scholarly journals Bioelastic properties of the aorta in children, adolescents and young adults after cardiac transplantation: a cardiovascular magnetic resonance study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Mueller ◽  
K Gummel ◽  
B Reich ◽  
H Latus ◽  
C Jux ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Cardiac Transplantation ◽  
Ascending Aorta ◽  
Control Group ◽  
Cross Sectional ◽  
Descending Aorta ◽  
Aortic Isthmus ◽  
Myocardial T1 ◽  
Study Population

Abstract Background Long-term complications after cardiac transplantation are common and typically include arterial hypertension and coronary allograft vasculopathy. Few studies also suggested that heart transplant recipients have an increased arterial stiffness. Purpose This prospective study aimed to assess the bioelastic properties of the aorta as well as LV function, morphology and structure in children and young adults after cardiac transplantation. Methods CMR studies from 34 patients (median age: 17.1 years, range: 8–24 years) who underwent cardiac transplantation in childhood were analysed. Aortic anatomy and distensibility were assessed at five locations of the thoracic aorta using steady-state free precession cine sequences. Pulse wave velocity (PWV) of the aortic arch and the descending thoracic aorta was measured from 2-dimensional phase contrast images. Size and function of the left atrium and the ventricles were assessed from a stack of short axis slices. Myocardial T1 times were determined using a standard MOLLI sequence. Results Cross-sectional areas of the ascending aorta and the aortic arch tended to be lower in patients compared to controls (ascending aorta 464.5±172.5 mm2 vs. 515.3±186.3 mm2, aortic arch 342.4±113.3 mm2 vs. 376.9±148.5 mm2) whereas cross-sectional areas of the descending aorta tended to be higher (aortic isthmus 283.7±102.1 mm2 vs. 257.9±89.5 mm2, aorta descendens diaphragmal 218.4±75.8 mm2 vs. 214.2±75.0 mm2) and showed a correlation with systolic blood pressure (r=0.33). PWV was higher in the aortic arch (4.8±2.4 m/s vs. 3.6±0.7 m/s). Aortic distensibility was slightly higher at all measuring points in the study population compared to the control group and showed an increase with rising distance from the heart (ascending aorta 10.5±5.8 10–3 mm Hg-1, aortic isthmus 13.1±7.5 10–3 mm Hg-1, descending aorta 16.6±6.8 10–3 mm Hg-1). Biventricular volumes were slightly reduced in the patient group compared to the control group but this was not statistically significant. Only left ventricular mass messured during the systolic phase was higher in the study population compared to the control group (males 55.1 g/m2 vs. 53.0 g/m2, females 46.2 g/m2 vs. 45.2 g/m2). T1 mapping demonstrated increased T1 times in the heart-transplanted group compared to published data in healthy adults. In particular, T1 times of the lateral and inferior myocardial segments were higher. Conclusion Patients who underwent cardiac transplantation in childhood seem to have a reduced bioelasticity of the thoracic aorta. Increased myocardial T1 times suggesting alterations in myocardial structure. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals The mechanical properties of fin whale arteries are explained by novel connective tissue designs.

1996 ◽  
Vol 199 (4) ◽  
pp. 985-997 ◽  
Author(s):  
J M Gosline ◽  
R E Shadwick
Keyword(s):  
Mechanical Properties ◽  
Elastic Modulus ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Collagen Fibre ◽  
External Diameter ◽  
Collagen Fibres ◽  
Descending Aorta ◽  
Fin Whale ◽  
Terrestrial Mammals

The aortic arch and the descending aorta in the fin whale (Balaenoptera physalus) are structurally and mechanically very different from comparable vessels in other mammals. Although the external diameter of the whale's descending thoracic aorta (approximately 12 cm) is similar to that predicted by scaling relationships for terrestrial mammals, the wall thickness:diameter ratio in the whale (0.015) is much smaller than the characteristic value for other mammals (0.05). In addition, the elastic modulus of the thoracic aorta (12 MPa at 13 kPa blood pressure) is about 30 times higher than in other mammals. In contrast, the whale's aortic arch has a wall thickness/diameter ratio (0.055) and an elastic modulus (0.4 MPa) that are essentially identical to those for other mammals. However, the aortic arch is unusual in that it can be deformed biaxially to very large strains without entering a region of high stiffness caused by the recruitment of fully extended collagen fibres. Chemical composition studies indicate that the elastin:collagen ratio is high in the aortic arch (approximately 2:1) and that this ratio falls in the thoracic (approximately 1:2) and abdominal (approximately 1:3) aortas, but the magnitude of the change in composition does not account for the dramatic difference in mechanical properties. This suggests that there are differences in the elastin and collagen fibre architecture of these vessels. The descending aorta contains dense bands of tendon-like, wavy collagen fibres that run in the plane of the arterial wall, forming a fibre-lattice that runs in parallel to the elastin lamellae and reinforces the wall, making it very stiff. The aortic arch contains a very different collagen fibre-lattice in which fibres appear to have a component of orientation that runs through the thickness of the artery wall. This suggests that the collagen fibres may be arranged in series with elastin-containing elements, a difference in tissue architecture that could account for both the lower stiffness and the extreme extensibility of the whale's aortic arch. Thus, both the structure and the mechanical behaviour of the lamellar units in the aortic arch and aorta of the whale have presumably been modified to produce the unusual mechanical and haemodynamic properties of the whale circulation.

Thoracic endograft placement using a transfemoral snare in a patient with angled aortic arch

Vascular ◽  
2021 ◽  
pp. 170853812110244
Author(s):  
Sencer Çamci ◽  
Selma Ari ◽  
Hasan Ari ◽  
Mehmet T Göncü
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Male Patient ◽  
Subclavian Artery ◽  
Femoral Artery ◽  
Left Subclavian Artery ◽  
Endovascular Aneurysm Repair ◽  
Descending Aorta ◽  
Thoracic Endovascular Aneurysm Repair ◽  
Aneurysm Repair

Objective In complex anatomical challenges, endovascular endograft implantation to the thoracic aorta may not be performed. Various techniques have been put forward for endograft therapy. In this report, we present the effect of femoral snare support for a patient with an aortic arch angle. Method Thoracic endovascular aneurysm repair (TEVAR) was used for treating a 60-year-old male patient who suffered from severe angulation in the arcus aorta and aneurysmal enlargement of the left subclavian artery and descending aorta. The endovascular graft could not be advanced into the aortic arch with the guidewire because of the aortic arch angle. Therefore, the TEVAR graft distal end was caught with the snare advanced from the femoral artery, and the TEVAR graft was advanced into the aortic arch. Conclusion and result The femoral snare technique is a simple and successful method for endograft implantation of the aortic arch disease without the risk of heart trauma, especially in cases with aortic arch tortuosity.

scholarly journals Blood flow in the rabbit aortic arch and descending thoracic aorta

2011 ◽  
Vol 8 (65) ◽  
pp. 1708-1719 ◽  
Author(s):  
P. E. Vincent ◽  
A. M. Plata ◽  
A. A. E. Hunt ◽  
P. D. Weinberg ◽  
S. J. Sherwin
Keyword(s):  
Blood Flow ◽  
Aortic Arch ◽  
Thoracic Aorta ◽  
Ductus Arteriosus ◽  
Local Variation ◽  
Descending Thoracic Aorta ◽  
Local Flow ◽  
Descending Aorta ◽  
Flow Features ◽  
Realistic Representation

The distribution of atherosclerotic lesions within the rabbit vasculature, particularly within the descending thoracic aorta, has been mapped in numerous studies. The patchy nature of such lesions has been attributed to local variation in the pattern of blood flow. However, there have been few attempts to model and characterize the flow. In this study, a high-order continuous Galerkin finite-element method was used to simulate blood flow within a realistic representation of the rabbit aortic arch and descending thoracic aorta. The geometry, which was obtained from computed tomography of a resin corrosion cast, included all vessels originating from the aortic arch (followed to at least their second generation) and five pairs of intercostal arteries originating from the proximal descending thoracic aorta. The simulations showed that small geometrical undulations associated with the ductus arteriosus scar cause significant deviations in wall shear stress (WSS). This finding highlights the importance of geometrical accuracy when analysing WSS or related metrics. It was also observed that two Dean-type vortices form in the aortic arch and propagate down the descending thoracic aorta (along with an associated skewed axial velocity profile). This leads to the occurrence of axial streaks in WSS, similar in nature to the axial streaks of lipid deposition found in the descending aorta of cholesterol-fed rabbits. Finally, it was observed that WSS patterns within the vicinity of intercostal branch ostia depend not only on local flow features caused by the branches themselves, but also on larger-scale flow features within the descending aorta, which vary between branches at different locations. This result implies that disease and WSS patterns in the vicinity of intercostal ostia are best compared on a branch-by-branch basis.

scholarly journals Relation of sympathetic activation and stress-induced hypertension in atherosclerosis of the thoracic aorta: a cadaveric study

2020 ◽  
Vol 7 (12) ◽  
pp. 3913
Author(s):  
Apostolos S. Gogakos ◽  
Triantafyllia D. Koletsa ◽  
Leonidas C. Pavlidis ◽  
Dimitrios A. Paliouras ◽  
Thomas S. Rallis ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Aortic Wall ◽  
Age Groups ◽  
Ascending Aorta ◽  
Variable Degree ◽  
Strong Negative Correlation ◽  
Descending Aorta ◽  
Induced Hypertension ◽  
Neuron Terminals

Background: The autonomic nervous system (ANS) has been associated with numerous atherosclerosis-induced cardiovascular events, such as myocardial infarction and aortic disease. Although evidence suggests a relationship between autonomic dysfunction and atherosclerotic disease, the underlying mechanisms are still under investigation. The purpose of this study is to investigate the effect of ANS to the development of atherosclerosis and vice versa, in human thoracic aorta.Methods: An autopsy analysis from three segments of the thoracic aorta was performed; ascending aorta, aortic arch, descending aorta, using 52 unselected adult cadavers (38 male, 14 female – mean age 64.4 years; age range 19-90 years). Subjects were divided in two age groups (<65 years – N=26, >65 years – N=26). Tissue specimens were macroscopically examined and histopathologically divided into 7 grades of scoring for atherosclerosis (ATHERO, from 0=intact, to 6=thrombi formation). The relationship between ANS and atherosclerosis was depicted by further immunohistochemical analysis for detection of neuron terminals onto the aortic wall. All data were evaluated according to the subjects’ demographic and clinical characteristics.Results: Total 96.2% of all subjects had atherosclerosis of variable degree in one or more segments. No aneurismal change was found. The presence of atheromas were common in all subjects regardless of age and segment, with atherosclerosis increasing by age; ascending aorta (r=0.571, p<0.001), aortic arch (r=0.655, p<0.001), descending aorta (r=0.659, p<0.001). Hypertension was a significant factor in the development of atherosclerosis in adults >65 years (r=0.450, p=0.023). In addition, a positive history of hypertension was statistically significant regarding both the presence of atherosclerosis and neuron terminals in all three aortic wall segments; ascending aorta (p=0.037), Aaortic arch (p=0.046), descending aorta (p=0.045). Furthermore, there was a strong negative correlation between the ATHERO score and the presence of neuron terminals in all three aortic segments; ascending aorta (r=-0.264, p=0.041), aortic arch (r=-0.400, p=0.003), descending aorta (r=-0.234, p=0.047).Conclusions: Human cadaveric studies are extremely useful in understanding the pathophysiology of ANS, along with clinical and animal studies that are most commonly performed. These data suggest that there is a link between autonomic disfunction and the presence of atherosclerosis in human thoracic aorta, especially when hypertension is present. It is therefore possible that stress-induced hypertension can be considered as a potential risk factor for the development of atherosclerosis.

Penetrating atherosclerotic ulcer aneurysm of the innominate artery

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 263-266 ◽  
Author(s):  
Yuan ◽  
Tager
Keyword(s):  
Conservative Treatment ◽  
Thoracic Aorta ◽  
Open Surgery ◽  
Innominate Artery ◽  
Ruptured Aneurysm ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Descending Aorta

Penetrating atherosclerotic ulcer of the aorta is uncommon, and usually develops in the descending thoracic aorta. Rarely this condition involves the branch vessels of the aorta. We report a case of ruptured aneurysm of the innominate artery resulting from penetrating atherosclerotic ulcer. Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta.

Aneurysm Hybrid Treatment by Simultaneous Replacement of Ascending Aorta and Aortic Arch and Endoluminal Stenting of the Descending Aorta

2006 ◽  
Vol 9 (1) ◽  
pp. E530-E532
Author(s):  
Friedrich-Christian Riess ◽  
Hans Krankenberg ◽  
Thilo Tübler ◽  
Matthias Danne
Keyword(s):  
Aortic Arch ◽  
Ascending Aorta ◽  
Descending Aorta ◽  
Hybrid Treatment

Type B Interrupted Aorta in an Adult Patient

2014 ◽  
Vol 17 (2) ◽  
pp. 80
Author(s):  
Ahmet Ozkara ◽  
Mehmet Ezelsoy ◽  
Levent Onat ◽  
Ilhan Sanisoglu
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Collateral Circulation ◽  
Neonatal Period ◽  
Interrupted Aortic Arch ◽  
Complete Loss ◽  
Posterolateral Thoracotomy ◽  
Type B ◽  
Case Presentation ◽  
Descending Aorta

<p><b>Introduction:</b> Interrupted aortic arch is a rare congenital malformation characterized by a complete loss of luminal continuity between the ascending and descending aorta. It is often diagnosed during the neonatal period.</p><p><b>Case presentation:</b> We presented a 51-year-old male patient with interrupted aortic arch type B who was treated successfully with posterolateral thoracotomy without using cardiopulmonary bypass.</p><p><b>Conclusion:</b> The prognosis for interrupted aortic arch depends on the associated congenital anomalies, but the outcome is usually very poor unless there is surgical treatment. Survival into adulthood depends on the development of collateral circulation.</p>

RF22 EXTRA-ANATOMIC BYPASS IN AN INFANT WITH SEVERE AORTIC ARCH AND THORACIC DESCENDING AORTA THROMBOSIS

2018 ◽  
Vol 19 ◽  
pp. e66
Author(s):  
S. Hoxha ◽  
G. Poretti ◽  
C. sandrini ◽  
L. barozzi ◽  
A. murari ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Descending Aorta
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