Bruce H. Smaill, PhDa, David C. McGiffin, MB, BS, FRACSb, Ian J

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Presentation transcript:

The effect of synthetic patch repair of coarctation on regional deformation of the aortic wall Bruce H. Smaill, PhDa, David C. McGiffin, MB, BS, FRACSb, Ian J. LeGrice, MB, BS, PhDa, Alistair A. Young, PhDa, Peter J. Hunter, DPhilc, Andrew J. Galbraith, BMedSc, MB, BS, FRACPd The Journal of Thoracic and Cardiovascular Surgery Volume 120, Issue 6, Pages 1053-1063 (December 2000) DOI: 10.1067/mtc.2000.110187 Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Diagram illustrating the way in which specimens of aorta were mounted for testing. The specimen and the compliant internal latex sleeve are secured to a cannula at each end. A synthetic patch is sutured to the aorta and a part of the matrix of marker points can be seen. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Schematic representation of the biplane video imaging system, vertically mounted specimen of aorta, and pressurization system. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Initially cylindrical finite element mesh fitted to the 3-D coordinates of aortic marker points. The small crosses represent reconstructed marker points from aorta #1 in unpatched reference state (11.2 mm Hg; 1.52 kPa). Normal projections from the shaded surface to these points indicate the residual error between the surface and marker points. The finite element surface was fitted by minimizing an error function that includes the squared sum of residuals. The rms error is 0.14 mm. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Finite element surfaces fitted to reconstructed marker points (small crosses) from aorta #6 viewed from above. a, Control: The inner reference data set was obtained at a pressure of 11.0 mm Hg (1.5 kPa), and the outer data set was obtained at 122.5 mm Hg (16.66 kPa). The rms errors for reference and deformed surfaces are 0.23 mm and 0.22 mm, respectively. b, Patched: The inner reference data set was obtained at a pressure of 9.7 mm Hg (1.32 kPa), and the outer data set was obtained at 125.9 mm Hg (17.12 kPa). The rms errors for reference and deformed surfaces are 0.42 mm and 0.44 mm, respectively. The patch was immediately to the right of the shaded surface . The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Circumferential and longitudinal curvatures as a function of pressure: ■ control circumferential curvature; ● circumferential curvature with patch; ♦ control longitudinal curvature; ▴ longitudinal curvature with patch. a, Mean curvatures for all 9 gauss quadrature points in aorta #6. Error bars indicate standard deviations for curvature. b, Grand mean for all studies. Error bars indicate standard deviations for curvature and pressure. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 6 First principal (major) and second principal (minor) extensions as a function of pressure: ■ control major extension; ● major extension with patch; ♦ control minor extension; ▴ minor extension with patch; ▵ control principal angle; ○ principal angle with patch. a, Mean principal extensions for all 9 gauss quadrature points in aorta #3. b, Grand mean for all studies. Error bars indicate standard deviations for principal extensions and pressure. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 7 Circumferential tension as a function of circumferential extension ratio. Material relationship (dashed line) fitted to control data (■). Average circumferential extensions after patch implantation (♦) are superimposed on the best-fit material relationship. The Journal of Thoracic and Cardiovascular Surgery 2000 120, 1053-1063DOI: (10.1067/mtc.2000.110187) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions