Tremblay Dominique, Zigras Tiffany, Cartier Raymond, Leduc Louis, Butany Jagdish, Mongrain Rosaire, Leask Richard L
Department of Chemical Engineering, McGill University, Montreal, Quebec, Canada.
Ann Thorac Surg. 2009 Nov;88(5):1484-91. doi: 10.1016/j.athoracsur.2009.07.023.
Differences in the mechanical properties of aortic tissues and replacement materials can have unwanted hemodynamic effects leading to graft failure. The aim of this experimental study was to compare the mechanical properties of different graft-patch materials used in aortic arch reconstruction with those of healthy and dilated human ascending aortas (AAs).
Four square samples were taken from 30 healthy (n = 120) and 14 dilated (n = 56) AA rings and from 34 human pericardial sections (fresh [n = 68] and Carpentiers solution fixed [n = 68]). In addition, square samples from commercial bovine pericardium (n = 14) were also compared with woven Dacron grafts (n = 24) and tested biaxially. Stress-strain curves (0% to 30%) were generated using a biaxial tensile tester to quantify the anisotropic properties and stiffness of the materials at 37 degrees C.
We found significant differences in stiffness and anisotropy among all material types. Fresh and fixed human pericardia, bovine pericardium, and Dacron were 9.5, 7.1, 16.4, and 18.4 times stiffer than dilated AAs, which was 1.3 times stiffer than healthy AAs under physiologic stretch. Only dilated and healthy AAs showed an increase in anisotropic properties with increasing strain.
The significant differences in the mechanical properties among all materials we found are intended to increase the awareness of these differences in materials used in aortic reconstruction surgery. This finding suggests that improvements are needed in prosthetic material design to better mimic native tissue.
主动脉组织与置换材料的力学性能差异可能产生不良的血流动力学效应,导致移植物失效。本实验研究的目的是比较用于主动脉弓重建的不同移植物补片材料与健康及扩张的人升主动脉(AA)的力学性能。
从30个健康的(n = 120)和14个扩张的(n = 56)AA环以及34个人心包切片(新鲜的[n = 68]和用Carpentiers溶液固定的[n = 68])中各取4个方形样本。此外,还将商业牛心包的方形样本(n = 14)与编织涤纶移植物(n = 24)进行比较,并进行双轴测试。使用双轴拉伸试验机生成应力-应变曲线(0%至30%),以量化材料在37℃时的各向异性特性和刚度。
我们发现所有材料类型在刚度和各向异性方面存在显著差异。新鲜和固定的人心包、牛心包和涤纶的刚度分别是扩张型AA的9.5、7.1、16.4和18.4倍,而扩张型AA在生理拉伸下比健康AA硬1.3倍。只有扩张型和健康型AA随应变增加各向异性特性增强。
我们发现的所有材料力学性能的显著差异旨在提高对主动脉重建手术中所用材料这些差异的认识。这一发现表明,假体材料设计需要改进,以更好地模拟天然组织。