Effect of aneurysm on the mechanical dissection properties of the human ascending thoracic aorta

Objectives: The acute dissection of an ascending thoracic aortic aneurysm (ATAA) represents a devastating separation of elastic layers occurring when the hemodynamic loads on the diseased wall exceed the adhesive strength between layers. At present, the mechanics underlying aortic dissection are largely unclear, and the biomechanical delamination properties of the aneurysmal aorta are not defined. Individuals with bicuspid aortic valve (BAV) are particularly predisposed to ascending aortic aneurysm formation, with a marked risk of aortic dissection. The purpose of this study was to evaluate and compare the dissection properties of nonaneurysmal and aneurysmal human ascending thoracic aorta …

Fiber Micro-Architecture in the Longitudinal-Radial and Circumferential-Radial Planes of Ascending Thoracic Aortic Aneurysm Media.

It was recently demonstrated by our group that the delamination strength of ascending thoracic aortic aneurysms (ATAA) was lower than that of control (CTRL, non-aneurysmal) ascending thoracic aorta (ATA), and the reduced strength was more pronounced among bicuspid (BAV) vs. tricuspid aortic valve (TAV) patients, suggesting a different risk of aortic dissection for BAV patients. We hypothesized that aortic valve morphologic phenotype predicts fiber micro-architectural anomalies in ATA. To test the hypothesis, we characterized the micro-architecture in the longitudinal-radial (Z-RAD) and circumferential-radial (Θ-RAD) planes of human ATA tissue that was artificially dissected medially. The ou…

Modeling in cardiovascular biomechanics

In this review, we briefly summarize some of Professor K.R. Rajagopal's contributions to the field of cardiovascular mechanics and highlight some applications that have employed his theories and have expanded the ability to model the complex behaviors that characterize biological tissues. His contributions, spawning directly from the classical nonlinear theories of mechanics, have had general impact in diverse fields of engineering. Within biomechanics per se, Rajagopal's efforts have provided state-of-the-art modeling tools not only to characterize tissues, such as blood vessels, cerebral aneurysms, or blood, but also to characterize their evolution, i.e. vessel growth and remodeling or bl…

A custom image-based analysis tool for quantifying elastin and collagen micro-architecture in the wall of the human aorta from multi-photon microscopy

The aorta possesses a micro-architecture that imparts and supports a high degree of compliance and mechanical strength. Alteration of the quantity and/or arrangement of the main load-bearing components of this micro-architecture - the elastin and collagen fibers - leads to mechanical, and hence functional, changes associated with aortic disease and aging. Therefore, in the future, the ability to rigorously characterize the wall fiber micro-architecture could provide insight into the complicated mechanisms of aortic wall remodeling in aging and disease. Elastin and collagen fibers can be observed using state-of-the-art multi-photon microscopy. Image-analysis algorithms have been effective at…

Evaluation of the stromal vascular fraction of adipose tissue as the basis for a stem cell-based tissue-engineered vascular graft

Abstract Objective One of the rate-limiting barriers within the field of vascular tissue engineering is the lengthy fabrication time associated with expanding appropriate cell types in culture. One particularly attractive cell type for this purpose is the adipose-derived mesenchymal stem cell (AD-MSC), which is abundant and easily harvested from liposuction procedures. Even this cell type has its drawbacks, however, including the required culture period for expansion, which could pose risks of cellular transformation or contamination. Eliminating culture entirely would be ideal to avoid these concerns. In this study, we used the raw population of cells obtained after digestion of human lipo…

Correlations between transmural mechanical and morphological properties in porcine thoracic descending aorta.

Determination of correlations between transmural mechanical and morphological properties of aorta would provide a quantitative baseline for assessment of preventive and therapeutic strategies for aortic injuries and diseases. A multimodal and multidisciplinary approach was adopted to characterize the transmural morphological properties of descending porcine aorta. Histology and multi-photon microscopy were used for describing the media layer micro-architecture in the circumferential-radial plane, and Fourier Transform infrared imaging spectroscopy was utilized for determining structural protein, and total protein content. The distributions of these quantified properties across the media thi…

Extracellular matrix fiber microarchitecture is region-specific in bicuspid aortic valve-associated ascending aortopathy

Abstract Objective Ascending thoracic aortic aneurysm (ATAA) in patients with bicuspid aortic valve (BAV) commonly dilate asymmetrically compared with patients with tricuspid aortic valve (TAV). This discrepancy in aneurysm geometry led us to hypothesize that microarchitectural differences underlie the observed asymmetric dilatation pattern. The purpose of this study was to characterize the microarchitectural distinctions of the extracellular matrix of the 2 phenotypes with a focus on the proportion of radially oriented elastin and collagen fibers in different circumferential aortic regions. Methods Aortic tissue rings were obtained just distal to the sinotubular junction from patients with…

In Vivo Functional Evaluation of Tissue-Engineered Vascular Grafts Fabricated Using Human Adipose-Derived Stem Cells from High Cardiovascular Risk Populations

Many preclinical evaluations of autologous small-diameter tissue-engineered vascular grafts (TEVGs) utilize cells from healthy humans or animals. However, these models hold minimal relevance for clinical translation, as the main targeted demographic is patients at high cardiovascular risk such as individuals with diabetes mellitus or the elderly. Stem cells such as adipose-derived mesenchymal stem cells (AD-MSCs) represent a clinically ideal cell type for TEVGs, as these can be easily and plentifully harvested and offer regenerative potential. To understand whether AD-MSCs sourced from diabetic and elderly donors are as effective as those from young nondiabetics (i.e., healthy) in the conte…

DISSECTION PROPERTIES OF ANEURYSMAL AND NONANEURYSMAL HUMAN ASCENDING THORACIC AORTA: PRELIMINARY RESULTS

Ascending thoracic aortic aneurysm (ATAA) is among the most devastating forms of cardiovascular disease, causing a significant mortality despite current medical and surgical treatments [1]. Moreover these therapies themselves are associated with great risk of mortality or morbidity, complicated by the advanced age of the typical patient, and high surgical costs. The mechanics of spontaneous aortic dissection is not fully understood. It is generally believed that aortic dissection initiates as an intimal tear in which a separation of wall layers produces the formation of a ‘false’ lumen. The dissection may propagate axially and/or circumferentially due to blood flow and pressure. Dissection …

Association of Fiber Orientation and Dissection Properties of Ascending Thoracic Aortic Aneurysms With Aortic Valve Morphology

Type A aortic dissection (AoD) of an ascending thoracic aortic aneurysm (ATAA) is a life-threatening cardiovascular emergency with a high potential for death. Despite improved surgical techniques, the morbidity risk for emergent surgery remains 24% worldwide according to data from the International Registry of Acute Aortic Dissection [1].Copyright © 2011 by ASME

A mechanistic model on the role of “radially-running” collagen fibers on dissection properties of human ascending thoracic aorta.

Aortic dissection (AoD) is a common condition that often leads to life-threatening cardiovascular emergency. From a biomechanics viewpoint, AoD involves failure of load-bearing microstructural components of the aortic wall, mainly elastin and collagen fibers. Delamination strength of the aortic wall depends on the load-bearing capacity and local micro-architecture of these fibers, which may vary with age, disease and aortic location. Therefore, quantifying the role of fiber micro-architecture on the delamination strength of the aortic wall may lead to improved understanding of AoD. We present an experimentally-driven modeling paradigm towards this goal. Specifically, we utilize collagen fib…

Framework for Fluid-Structure Interaction Analysis of Aortic Coarctation Resulting From Proximal Protusion of Thoracic Aortic Stent Graft Into the Arch

Thoracic aortic stent grafts (TASG) are commonly used to repair aortic anomalies or diseases in a minimally-invasive fashion. One complication of TASG is collapse, whereby blood is unable to completely flow through the graft as intended. Most TASG collapses occur in the setting of endovascular repair of traumatic thoracic aortic transection, where a typically smaller diameter aorta of pediatric patients is repaired with a relatively larger diameter endograft designed to treat aneurysmal disease [1]. It is hypothesized that the poor apposition of the leading edge of the proximal stent graft to the lesser curvature of the aortic arch can result increased hemodynamic force at the leading side …

FIBER DISTRIBUTION OF ASCENDING THORACIC AORTIC ANEURYSMS ASSOCIATED WITH VALVE MORPHOLOGY

Computer Modeling for the Prediction of Thoracic Aortic Stent Graft Collapse

OBJECTIVE: To assess the biomechanical implications of excessive stent protrusion into the aortic arch in relation to thoracic aortic stent graft (TASG) collapse by simulating the structural load and quantifying the fluid dynamics on the TASG wall protrusion extended into a model arch. METHODS: One-way coupled fluid-solid interaction analyses were performed to investigate the flow-induced hemodynamic and structural loads exerted on the proximal protrusion of the TASG and aortic wall reconstructed from a patient who underwent traumatic thoracic aortic injury repair. Mechanical properties of a Gore TAG thoracic endoprosthesis (W. L. Gore and Assoc, Flagstaff, Ariz) were assessed via experimen…

Difference in hemodynamic and wall stress of ascending thoracic aortic aneurysms with bicuspid and tricuspid aortic valve.

The aortic dissection (AoD) of an ascending thoracic aortic aneurysm (ATAA) initiates when the hemodynamic loads exerted on the aneurysmal wall overcome the adhesive forces holding the elastic layers together. Parallel coupled, two-way fluid–structure interaction (FSI) analyses were performed on patient-specific ATAAs obtained from patients with either bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) to evaluate hemodynamic predictors and wall stresses imparting aneurysm enlargement and AoD. Results showed a left-handed circumferential flow with slower-moving helical pattern in the aneurysm's center for BAV ATAAs whereas a slight deviation of the blood flow toward the anterolater…

Biomechanics and Pathobiology of Aortic Aneurysms

Biomechanical weakening of the aorta leads to aneurysm formation and/or dissection and total biomechanical failure results in rupture, which is often fatal. The most common aneurysm is the abdominal aortic aneurysm (AAA) whereas thoracic aortic aneurysms (TAA) involve the ascending or descending segments of the aorta. Biomechanical strength of the aorta is maintained in part via balance between the integrity of the aortic medial and adventitial extracellular matrix and the health of the mural cells. From a biomechanical perspective, aneurysms rupture or dissect when wall stresses locally exceed the wall strength. Pathobiologic mechanisms, pre-disposing disorders and variability of patient d…

Constitutive modeling of ascending thoracic aortic aneurysms using microstructural parameters.

Ascending thoracic aortic aneurysm (ATAA) has been associated with diminished biomechanical strength and disruption in the collagen fiber microarchitecture. Additionally, the congenital bicuspid aortic valve (BAV) leads to a distinct extracellular matrix structure that may be related to ATAA development at an earlier age than degenerative aneurysms arising in patients with the morphological normal tricuspid aortic valve (TAV). The purpose of this study was to model the fiber-reinforced mechanical response of ATAA specimens from patients with either BAV or TAV. This was achieved by combining image-analysis derived parameters of collagen fiber dispersion and alignment with tensile testing dat…