Abstract
Purpose
To quantify cardiac and respiratory deformations of the thoracic aorta after ascending aortic graft repair.
Methods
Eight patients were scanned with cardiac-resolved computed tomography angiography during inspiratory/expiratory breath-holds. Aortic centerlines and lumen were extracted to compute the arclength, curvature, angulation, and cross-section shape.
Results
From systole to diastole, the angle of graft \(\sim \) arch increased by 2.4\({^{\circ }}\) ± 1.8\({^{\circ }}\) (P < 0.01) and the angle of arch \(\sim \) descending aorta decreased by 2.4\({^{\circ }}\) ± 2.6\({^{\circ }}\) (P < 0.05), while the effective diameter of the proximal arch decreased by 2.4 ± 1.9% (P < 0.01), a greater change than those of the graft or distal arch (P < 0.05). From inspiration to expiration, the angle of graft \(\sim \) arch increased by 2.8\({^{\circ }}\) ± 2.6\({^{\circ }}\) (P < 0.02) with the peak curvature increase (P < 0.05). Shorter graft length was correlated with greater cardiac-induced graft \(\sim \) arch angulation, and longer graft length was correlated with greater respiratory-induced arch \(\sim \) descending aorta angulation (R \(\ge \) 0.50).
Conclusion
The thoracic aorta changed curvature and angulation with cardiac and respiratory influences, driven by aortic root and arch motion. The thoracic aortic geometry and deformation are correlated with the ascending aortic graft length.
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Acknowledgements
Authors acknowledge Lior Molvin, Daisha Marsh, and staffs in Stanford Radiology East, Sherman Medical Imaging Center, and Vascular Surgery for their support on CT imaging and recruitment. Also, authors thank Riley Marangi for his support on 3D modeling. The authors would like to thank all patients for their participation.
Funding Ga-Young Suh and Christopher P. Cheng received a research gift from Medtronic Vascular (Santa Rosa, CA).
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Ramin Beygui and Dominik Fleischmann declare that they have no conflict of interest.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was acquired from all individual participants included in the study.
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Suh, GY., Fleischmann, D., Beygui, R.E. et al. Quantification of motion of the thoracic aorta after ascending aortic repair of type-A dissection. Int J CARS 12, 811–819 (2017). https://doi.org/10.1007/s11548-016-1499-8
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DOI: https://doi.org/10.1007/s11548-016-1499-8