Details

Autor(en) / Beteiligte

• Veger, H.T.C., MD
• Pasveer, E.H
• Visser, M.J.T., MD PhD

Titel

Where to fenestrate in aortic dissection type B? An Ex-vivo Study

Ist Teil von

• Annals of vascular surgery, 2017-08, Vol.43, p.296-301

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Purpose Fenestration is a minimally invasive alternative for the treatment of acute symptomatic aortic dissections because it may quickly decrease the pressure gradient of the false lumen. It remains unclear where the optimal location of these fenestrations should be chosen. The purpose of this study was to study false lumen volume after different fenestration strategies in porcine ex-vivo models of aortic type B dissection. Materials and Methods An artificial dissection was created in ex-vivo porcine aortas. A total number of six aortic dissection models were made. The dissection flap was divided in three equal parts; proximal, mid and distal sections. In three models a fenestration was made in the center of the proximal section of the dissection flap. In the three others in the center of the distal part of the dissection flap. The aorta was positioned in a validated in vitro circulatory system with physiological pulsatile flow. Volume-measurements of true lumen volume (TLV) and false lumen volume (FLV) were assessed with computed tomography. Results Performing a fenestration in the proximal part of the dissection flap resulted in FLV increase in two of the three models. Performing a fenestration in the distal part of the dissection flap resulted in FLV decrease in all three models. False lumen reduction was obtained significantly in the distally fenestrated models compared to the proximally fenestrated models (9.6±3.5% vs. 0.7±2.9%, p=0.03 ) Conclusion In this ex-vivo study, we showed that distal fenestration of the false lumen in aortic dissection will result in the largest false lumen reduction.