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

机译:动脉瘤和非肌肉瘤人升胸主动脉的解剖特性:初步结果

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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 may lead to several possible complications. For example, the septum between the false lumen and true lumen may fracture, resulting in embolism and ischemic damage. Another possibility is that the thinned and weakened residual outer aortic wall may fail, resulting in rapid blood loss and tamponade. From a mechanical point of view, aortic dissection is due to the combination of hemodynamic loads acting on the intimal layer and the laminar structure of the aortic wall with different elastic properties. Since the aorta is an anisotropic and inhomogeneous body, it is possible that the hemodynamic loads (including mural shear) produce stresses of the appropriate types and magnitudes that result in delamination of the aortic layers [2]. That is, dissection initiates when the hemodynamic loads overcome the adhesive forces holding the layers together. The effects of the loads are of course accentuated in the case of a disorganized microstructure and degenerated tissue that is typical in aneurysmal disease.
机译:升胸主动脉动脉瘤(ATAA)是最具破坏性的心血管疾病形式之一,尽管目前的医疗和手术治疗,致以显着的死亡率[1]。此外,这些疗法本身与典型患者的先进年龄复杂的死亡率或发病率很大,以及高手术成本。自发主动脉夹层的机制尚未完全理解。通常认为主动脉夹层引发作为一种内膜撕裂,其中壁层的分离产生“假”腔的形成。解剖可以由于血流和压力而轴向和/或周向传播。解剖可能导致几种可能的并发症。例如,假腔和真腔之间的隔膜可能会破裂,导致栓塞和缺血性损害。另一种可能性是稀释和弱化的残余外主动脉壁可能会发生故障,导致血液损失快速和铺隙液。从机械的角度来看,主动脉夹层是由于作用于内膜层的血流动力载荷和主动脉壁的层状结构,具有不同的弹性性质。由于主动脉是各向异性和不均匀的体,因此血流动力载荷(包括壁剪)可能产生适当类型和幅度的应力,从而导致主动脉层的分层[2]。也就是说,当血流动力载荷克服将夹持层的粘合力克服将粘合力一起克服时,解剖引起。在动脉瘤疾病中典型的混乱微观结构和退化组织的情况下,载荷的效果当然突出。

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