Early distal remodeling after elephant trunk repair of thoraco-abdominal aortic aneurysms

Salvatore Pasta, Francesco Scardulla, Michele Pilato, Giuseppe M Raffa, Giovanni Gentile, Salvatore Pasta, Fabrizio Follis, Bryan Wu, Giuseppe M Raffa, Giuseppe D'Ancona, Giovanni Domenico Gentile

Risultato della ricerca: Articlepeer review

2 Citazioni (Scopus)


Hemodynamic alterations occur when the elephant trunk (ET) technique is adopted to treat extensive aortic aneurysms. In planning the 2nd stage operation to complete ET repair, surgeons must weigh an adequate recovery time after initial surgery against the risk of postoperative ET-related complications. The purpose of this study was to understand the mechanistic link between the flow alteration caused by the ET graft and the development of premature aortic rupture before the 2nd stage operation. Specifically, fluid-structure interaction (FSI) analysis was performed using the CT imaging data of aorta at different stages of ET repair, and then computational variables were compared to those observed in patients who underwent a prophylactic 2nd stage operation to complete aortic repair. Results show that intramural stress exerted near the distal ET anastomosis (IMS=37.5 kPa) at the time of urgent intervention was comparable to that of the extensive aortic aneurysm (IMS=47.4 kPa) at initial in-hospital admission, but was considerably higher than that occurring after the 1st stage procedure (IMS=3.5 kPa). Pressure index suggested higher peri-graft pressurization than aortic lumen pressure during diastole, imparting an apparent risk of aortic dilatation. These critical hemodynamic and structural parameters are related to the impending rupture of descending aorta observed clinically and can thus guide prophylactic intervention and optimal timing for the 2nd stage operation of a ET technique.
Lingua originaleEnglish
pagine (da-a)2398-2404
Numero di pagine7
RivistaJournal of Biomechanics
Stato di pubblicazionePublished - 2016

All Science Journal Classification (ASJC) codes

  • ???subjectarea.asjc.1300.1304???
  • ???subjectarea.asjc.2200.2204???
  • ???subjectarea.asjc.2700.2732???
  • ???subjectarea.asjc.2700.2742???


Entra nei temi di ricerca di 'Early distal remodeling after elephant trunk repair of thoraco-abdominal aortic aneurysms'. Insieme formano una fingerprint unica.

Cita questo