Original articleAdult cardiacWall Stress Distribution in Bicuspid Aortic Valve–Associated Ascending Thoracic Aortic Aneurysms
Section snippets
Material and Methods
Patients with electrocardiogram-gated computed tomography angiography (CTA) undergoing routine aneurysm surveillance were evaluated for BAV-aTAA with diameter greater than 4.5 cm. Patients with motion artifact or poor image quality resolution were excluded. Patients were required to have neither a history of aortic valve surgery nor isolated aortic root dilatation. BAVs were not differentiated by subtype. This study was approved by the Committee on Human Research at the University of California
Clinical Profiles
There were 41 male BAV-aTAA patients, with mean age of 66 ± 9 years. Mean aTAA diameter was 5.05 ± 0.46 cm. Patient characteristics are summarized in Table 1.
BAV-aTAA Wall Stresses
There was a significant effect of region on peak circumferential wall stresses for the sinuses (474 ± 88.2 kPa), STJ (634 ± 181.9 kPa), and AscAo (381 ± 54.0 kPa) at systolic pressure (F = 46, P < 1 × 10-12), which were significantly lower at the AscAo than in the sinuses (P = .002) and STJ (P < 1 × 10-13), and higher in the STJ than in
Comment
Current American College of Cardiology/American Heart Association aTAA surgical repair guidelines base their recommendations primarily on diameter, along with growth rate, connective tissue disorder, and family history of dissection.6 We, among others, demonstrated that aTAA diameter is not a good predictor for aneurysm dissection or rupture.7, 8, 9,16,19 Biomechanical studies suggest higher wall strength of BAV than TAV-aTAAs,12, 13, 14 highlighting the importance of patient-specific wall
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