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False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection

OBJECTIVES: We aimed to determine whether non-A non-B aortic dissection (AD) differs in morphologic and haemodynamic properties from type B AD. METHODS: We simulated and compared haemodynamics of patients with acute type B or acute non-A non-B AD by means of computational fluid dynamics. Wall pressu...

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Autores principales: Kimura, Naoyuki, Nakamura, Masanori, Takagi, Reiya, Mieno, Makiko Naka, Yamaguchi, Atsushi, Czerny, Martin, Beyersdorf, Friedhelm, Kari, Fabian Alexander, Rylski, Bartosz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486891/
https://www.ncbi.nlm.nih.gov/pubmed/35552699
http://dx.doi.org/10.1093/icvts/ivac138
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author Kimura, Naoyuki
Nakamura, Masanori
Takagi, Reiya
Mieno, Makiko Naka
Yamaguchi, Atsushi
Czerny, Martin
Beyersdorf, Friedhelm
Kari, Fabian Alexander
Rylski, Bartosz
author_facet Kimura, Naoyuki
Nakamura, Masanori
Takagi, Reiya
Mieno, Makiko Naka
Yamaguchi, Atsushi
Czerny, Martin
Beyersdorf, Friedhelm
Kari, Fabian Alexander
Rylski, Bartosz
author_sort Kimura, Naoyuki
collection PubMed
description OBJECTIVES: We aimed to determine whether non-A non-B aortic dissection (AD) differs in morphologic and haemodynamic properties from type B AD. METHODS: We simulated and compared haemodynamics of patients with acute type B or acute non-A non-B AD by means of computational fluid dynamics. Wall pressure and wall shear stress (WSS) in both the true lumen (TL) and false lumen (FL) at early, mid- and late systole were evaluated. Morphology, WSS and the FL/TL wall pressure ratio were compared between groups. RESULTS: Nineteen patients (type B, n = 7; non-A non-B, n = 12) were included. The median age (51 [46, 67] vs 53 [50, 63] years; P = 0.71) and a complicated course (14% vs 33%; P = 0.6) did not differ between the type B group and the non-A non-B group. However, the median entry tear width was increased in the non-A non-B group (9.7 [7.3, 12.7] vs 16.3 [11.9, 24.9] mm; P = 0.010). Streamlines showed, in patients with non-A non-B AD, blood from the TL flowed into the FL via the entry tear. Prevalence of a FL/TL wall pressure ratio >1.0 (type B versus non-A non-B) at early, mid- and late systole was 57% vs 83% (P = 0.31), 43% vs 83% (P = 0.13) and 57% vs 75% (P = 0.62), respectively. WSS did not differ between the groups. CONCLUSIONS: The increased FL/TL wall pressure ratio observed during systole in non-A non-B AD may beget a complicated presentation.
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spelling pubmed-94868912022-09-20 False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection Kimura, Naoyuki Nakamura, Masanori Takagi, Reiya Mieno, Makiko Naka Yamaguchi, Atsushi Czerny, Martin Beyersdorf, Friedhelm Kari, Fabian Alexander Rylski, Bartosz Interact Cardiovasc Thorac Surg Vascular OBJECTIVES: We aimed to determine whether non-A non-B aortic dissection (AD) differs in morphologic and haemodynamic properties from type B AD. METHODS: We simulated and compared haemodynamics of patients with acute type B or acute non-A non-B AD by means of computational fluid dynamics. Wall pressure and wall shear stress (WSS) in both the true lumen (TL) and false lumen (FL) at early, mid- and late systole were evaluated. Morphology, WSS and the FL/TL wall pressure ratio were compared between groups. RESULTS: Nineteen patients (type B, n = 7; non-A non-B, n = 12) were included. The median age (51 [46, 67] vs 53 [50, 63] years; P = 0.71) and a complicated course (14% vs 33%; P = 0.6) did not differ between the type B group and the non-A non-B group. However, the median entry tear width was increased in the non-A non-B group (9.7 [7.3, 12.7] vs 16.3 [11.9, 24.9] mm; P = 0.010). Streamlines showed, in patients with non-A non-B AD, blood from the TL flowed into the FL via the entry tear. Prevalence of a FL/TL wall pressure ratio >1.0 (type B versus non-A non-B) at early, mid- and late systole was 57% vs 83% (P = 0.31), 43% vs 83% (P = 0.13) and 57% vs 75% (P = 0.62), respectively. WSS did not differ between the groups. CONCLUSIONS: The increased FL/TL wall pressure ratio observed during systole in non-A non-B AD may beget a complicated presentation. Oxford University Press 2022-05-13 /pmc/articles/PMC9486891/ /pubmed/35552699 http://dx.doi.org/10.1093/icvts/ivac138 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Vascular
Kimura, Naoyuki
Nakamura, Masanori
Takagi, Reiya
Mieno, Makiko Naka
Yamaguchi, Atsushi
Czerny, Martin
Beyersdorf, Friedhelm
Kari, Fabian Alexander
Rylski, Bartosz
False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection
title False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection
title_full False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection
title_fullStr False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection
title_full_unstemmed False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection
title_short False lumen/true lumen wall pressure ratio is increased in acute non-A non-B aortic dissection
title_sort false lumen/true lumen wall pressure ratio is increased in acute non-a non-b aortic dissection
topic Vascular
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486891/
https://www.ncbi.nlm.nih.gov/pubmed/35552699
http://dx.doi.org/10.1093/icvts/ivac138
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