The susceptibility of the aortic root: porcine aortic rupture testing under cardiopulmonary bypass.

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dc.contributor.authorSurman, T.L.
dc.contributor.authorAbrahams, J.M.
dc.contributor.authorManavis, J.
dc.contributor.authorFinnie, J.
dc.contributor.authorChristou, C.
dc.contributor.authorWilliams, G.K.
dc.contributor.authorWalls, A.
dc.contributor.authorFrantzis, P.
dc.contributor.authorAdams, M.
dc.contributor.authorEdwards, J.
dc.contributor.authorWorthington, M.G.
dc.contributor.authorBeltrame, J.
dc.date.issued2021
dc.description.abstractBackground: In our earlier study on the functional limits of the aneurysmal aortic root we determined the pig root is susceptible to failure at high aortic pressures levels. We established a pig rupture model using cardiopulmonary bypass to determine the most susceptible region of the aortic root under the highest pressures achievable using continuous flow, and what changes occur in these regions on a macroscopic and histological level. This information may help guide clinical management of aortic root and ascending aorta pathology. Methods: Five pigs underwent 4D flow MRI imaging pre surgery to determine vasopressor induced wall sheer stress and flow parameters. All pigs were then placed on cardiopulmonary bypass (CPB) via median sternotomy, and maximal aortic root and ascending aorta flows were initiated until rupture or failure, to determine the most susceptible region of the aorta. The heart was explanted and analysed histologically to determine if histological changes mirror the macroscopic observations. Results: The magnetic resonance imaging (MRI) aortic flow and wall sheer stress (WSS) increased significantly in all regions of the aorta, and the median maximal pressures obtained during cardiopulmonary bypass was 497 mmHg and median maximal flows was 3.96 L/m. The area of failure in all experiments was the non-coronary cusp of the aortic valve. Collagen and elastin composition (%) was greatest in the proximal regions of the aorta. Collagen I and III showed greatest content in the inner aortic root and ascending aorta regions. Conclusions: This unique porcine model shows that the aortic root is most susceptible to failure at high continuous aortic pressures, supported histologically by different changes in collagen content and subtypes in the aortic root. With further analysis, this information could guide management of the aortic root in disease.
dc.description.statementofresponsibilityTimothy Luke Surman, John Matthew Abrahams, Jim Manavis, John Finnie, Chris Christou, Georgia Kate Williams, Angela Walls, Peter Frantzis, Mark Adams, James Edwards, Michael George Worthington, and John Beltrame
dc.identifier.citationJournal of Cardiothoracic Surgery, 2021; 16(1):283-1-283-12
dc.identifier.doi10.1186/s13019-021-01667-9
dc.identifier.issn1749-8090
dc.identifier.issn1749-8090
dc.identifier.orcidManavis, J. [0000-0001-7381-7781] [0000-0003-1268-561X]
dc.identifier.orcidFinnie, J. [0000-0003-2277-1693]
dc.identifier.orcidChristou, C. [0000-0003-3231-0356]
dc.identifier.orcidBeltrame, J. [0000-0002-4294-6510]
dc.identifier.urihttps://hdl.handle.net/2440/146107
dc.language.isoen
dc.publisherBMC
dc.rights© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
dc.source.urihttps://doi.org/10.1186/s13019-021-01667-9
dc.subjectAortic aneurysms; Cardiopulmonary bypass; Animal model; Histology; Wall sheer stress
dc.subject.meshAorta
dc.subject.meshAortic Valve
dc.subject.meshAnimals
dc.subject.meshSwine
dc.subject.meshAortic Rupture
dc.subject.meshAortic Aneurysm, Thoracic
dc.subject.meshCardiopulmonary Bypass
dc.titleThe susceptibility of the aortic root: porcine aortic rupture testing under cardiopulmonary bypass.
dc.typeJournal article
pubs.publication-statusPublished

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