Towards an understanding of the mechanics underlying aortic dissection |
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Authors: | Keshava Rajagopal Craig Bridges K R Rajagopal |
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Institution: | (1) Department of Surgery, Duke University, Durham, NC, USA;(2) Department of Mechanical Engineering, Texas A&M University, College Station, TX 77843-3123, USA |
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Abstract: | Acute aortic dissection and associated aortic catastrophes are among the most devastating forms of cardiovascular disease,
with a remarkably high morbidity and mortality despite current medical and surgical treatment. The mechanics underlying aortic
dissection are incompletely understood, and a further understanding of the relevant fluid and solid mechanics may yield not
only a better appreciation of its pathogenesis, but also the development of improved diagnostic and therapeutic strategies.
After illustrating some of the inadequacies with respect to the extant work on the mechanics of aortic dissection, we alternatively
postulate that the clinical hemodynamic disturbances that render the aorta susceptible to the initiation of dissection are
principally elevated maximum systolic and mean aortic blood pressure, whereas the hemodynamic disturbances that facilitate
propagation of dissection are principally elevated pulse pressure and heart rate. Furthermore, abnormal aortic mechanical
properties and/or geometry are requisite for dissection to occur. Specifically, we propose that the degree of anisotropy will
directly influence the probability of future aortic dissection. Imaging of the aorta may provide information regarding aortic
anisotropy and geometry, and in combination with a hemodynamic risk assessment, has the potential to be able to prospectively
identify patients at high risk for future aortic dissection thereby facilitating prophylactic intervention. The aim of the
paper is to identify the main mechanical issues that have a bearing on aortic dissection, and to suggest an appropriate mathematical
model for describing the problem. |
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Keywords: | Cardiovascular Aorta Dissection Mechanics Hemodynamics Anisotropy |
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