Original articleAdult cardiacDifferential Tensile Strength and Collagen Composition in Ascending Aortic Aneurysms by Aortic Valve Phenotype
Section snippets
Tissue Harvest
Whole, fresh, nondissecting ascending aortic specimens were harvested as an intact tubular structure (Fig 1A) from patients with BAV (age, 54 ± 4 years; diameter, 50 ± 5 mm, mean ± standard deviation; n = 23) and TAV (age, 66 ± 11 years; diameter, 57 ± 14 mm; n = 15) undergoing elective surgery. All tissues were excised after obtaining informed patient consent in accordance with a study protocol approved by our institutional review board. The tissue was harvested from above the sinuses of
Results
A total of 23 ATAAs with BAV and 15 ATAAs with TAV were included in this study. The average maximal orthogonal diameter of the aorta was 50 ± 5 mm for BAV versus 57 ± 14 mm for TAV (p = 0.15). The age discrepancy noted is consistent with the clinical observation that BAV ATAAs present 10 to 20 years earlier than patients with TAV and ATAA [17]. From these ATAAs, 178 samples were tensile tested; 15 of those were either slipped or broke at the clamp, and hence were discarded from data analysis.
Comment
Aortic dissection or rupture represents a mechanical failure of the aortic wall, which can occur when aortic wall integrity is altered. Despite a higher percentage of patients with BAV compared with TAV among the aortic dissection population than among the general population [18], no investigation has been done, to our knowledge, on the condition of ATAA wall tensile strength with respect to valve phenotype. This study found differences in the wall strength between ATAAs from BAV and TAV
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These authors contributed equally to this work.