Endografting of the descending thoracic aorta increases ascending aortic input impedance and attenuates pressure transmission in dogs.

OBJECTIVES Endografting is being used to manage aneurysms, dissections and acute traumatic disruptions of the thoracic aorta. The acute effects of such interventions on ventricular afterload and on pressure wave transmission characteristics are not well known. METHODS In five dogs, a 55 mm endograft was introduced into the descending aorta, just distal to the left subclavian artery, with oversizing of 20%. Following formaldehyde induced complete heart block, the hearts were paced (30-120bpm). The ascending aortic pressures and flows were recorded using Millar micro-tip manometers and ultrasonic flowmeters, respectively. Arterial pressures proximal and distal to the stent site were also recorded. For each heart rate, parameters of a modified Windkessel (SVR: systemic vascular resistance, Z0: characteristic impedance, C: total arterial compliance) were estimated. The pulse wave velocity (PWV) and reflection coefficient (Gamma) were calculated from the pressure wave transfer functions. RESULTS The Z0 (0.25+/-0.05 vs 0.41+/-0.06 mmHg/ml s(-1), P<.05) was increased and C was decreased (0.45+/-0.07 vs 0.28+/-0.04 ml/mmHg, P<0.001) following endograft placement. SVR tended to increase (P=.06) and ascending aortic Gamma was unchanged. The PWV increased (418+/-67 vs 755+/-135 cm/s, P<.05) and the distal Gamma decreased (0.09+/-0.10 vs -0.49+/-0.07, P<.05). CONCLUSIONS Endografting in the proximal descending aorta cause unfavorable changes in the ascending aortic input impedance and an increase in the PWV through the grafted segment, consistent with an increase in the modulus of elasticity. The grafts produce a negative Gamma at the distal end, an uncommon occurrence in the systemic circulation. Whether this change is of sufficient magnitude to result in post-graft dilation is unknown.

• Publication year

  2006

• Venue

  European Journal of Vascular and Endovascular Surgery

• Publication date

  2006-08-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/J.EJVS.2006.01.020PMID 16564712
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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  2009cited by this paper
• Editorial

  2008cited by this paper
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  2005cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2004cited by this paper
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  2003cited by this paper
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  2003cited by this paper
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  2003cited by this paper
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  2003cited by this paper
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  2002cited by this paper
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  2002cited by this paper
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  2002cited by this paper
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  2002cited by this paper
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  2001cited by this paper
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  2000cited by this paper
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  2000cited by this paper
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  1999cited by this paper
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  1999cited by this paper
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  1999cited by this paper
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  1998cited by this paper
• An Experimental Study of Endovascular Stenting with Special Reference to the Effects on the Aortic Vasa Vasorum

  1998cited by this paper
• Gosling's Doppler pulsatility index revisited.

  1998cited by this paper
• Effect of vasa vasorum flow on structure and function of the aorta in experimental animals.

  1995cited by this paper
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  1995cited by this paper
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  1995cited by this paper
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  1994cited by this paper
• Changes in arterial wall compliance after endovascular stenting.

  1994cited by this paper
• Effect of reduced aortic compliance on cardiac efficiency and contractile function of in situ canine left ventricle.

  1992cited by this paper
• Elastic Characteristics of the Self‐expanding Metallic Stents

  1988cited by this paper
• Is compliance mismatch the major cause of anastomotic arterial aneurysms? Analysis of 42 cases.

  1985cited by this paper
• Stroke volume effect of changing arterial input impedance over selected frequency ranges.

  1985cited by this paper
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  1985cited by this paper

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  2023cites this paper
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  2023cites this paper
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  2023cites this paper
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  2023cites this paper
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  2022cites this paper
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  2022cites this paper
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  2022cites this paper
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  2021cites this paper
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  2020cites this paper
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  2020cites this paper
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  2020cites this paper
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  2020cites this paper
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  2019cites this paper
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  2019cites this paper
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  2019cites this paper
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  2018cites this paper
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  2018cites this paper
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  2018cites this paper
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  2018cites this paper
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  2018cites this paper
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  2017cites this paper
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  2017cites this paper
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  2017cites this paper
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  2017cites this paper
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  2017cites this paper
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  2017cites this paper
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  2017cites this paper
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  2017cites this paper
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  2016cites this paper
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  2016cites this paper
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  2016cites this paper
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  2016cites this paper
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  2014cites this paper
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  2013cites this paper
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  2013cites this paper
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  2013cites this paper
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  2012cites this paper
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  2012cites this paper
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  2012cites this paper
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  2012cites this paper
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  2012cites this paper
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  2012cites this paper
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  2012cites this paper
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  2012cites this paper
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  2011cites this paper
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  2011cites this paper
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  2011cites this paper
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  2010cites this paper
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  2010cites this paper
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  2010cites this paper
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  2009cites this paper
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  2008cites this paper
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  2007cites this paper
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  2007cites this paper
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  year unknowncites this paper
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  year unknowncites this paper
• Aneurysmsthe Treatment of Anterior Circulation Hemorrhage Following Flow Diversion for Delayed Ipsilateral Parenchymal

  year unknowncites this paper