Comparison of arterial stiffness and microcirculatory changes following abdominal aortic aneurysm grafting.
BACKGROUND
Abdominal aortic aneurysm (AAA) surgery provides a unique opportunity to study the impact of arterial stiffness on central haemodynamics, reflected in augmentation index (AI). The aneurysmal aorta is significantly stiffer than undilated age-matched aorta.


OBJECTIVE
We investigated whether replacement of an aneurysmal aorta with a compliant graft would result in a decrease in AI, which would thus decrease myocardial workload parameters.


METHODS
Patients undergoing elective open or endovascular AAA repair were assessed with applanation tonometry and laser fluximetry pre-operatively, immediately and long-term post-operatively.


RESULTS
Replacement of a small segment of abnormal conduit vessel resulted in improvements in AI, demonstrating that arterial stiffness can be surgically manipulated.


CONCLUSIONS
These results reflect a decreased myocardial workload post-aortic grafting. This decrease in AI is important from a risk factor management perspective, and arterial stiffness should become a further recognised and screened for risk factor in patients with known aneurysmal disease.
Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Beaumont, Dublin 9, Ireland. tmoloney90@hotmail.com
M A
MA
Moloney
S
S
McHugh
D H
DH
O' Donnell
R G
RG
Casey
E G
EG
Kavanagh
P A
PA
Grace
P
P
Fitzgerald
D J
DJ
Bouchier-Hayes
D000368:Aged; D001012:Aorta, Abdominal / Q000503:physiopathology; D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology* / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology; D004548:Elasticity / Q000502:physiology*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008365:Manometry; D008833:Microcirculation / Q000502:physiology*; D016378:Tissue Transplantation / Q000502:physiology