title: Aortic arch vessel geometries and deformations in patients with thoracic aortic aneurysms and dissections.
abstract: OBJECTIVE
  To quantify aortic arch geometry and in vivo cardiac-induced and respiratory-induced arch translations and arch branch angulations using three-dimensional geometric modeling techniques.
  
  
  METHODS
  Scanning with electrocardiogram-gated computed tomography angiography during inspiratory and expiratory breath holds was performed in 15 patients (age, 64 y ± 14) with thoracic aortic aneurysms or dissections. From the lumen models, centerlines of the thoracic aorta, brachiocephalic artery, left common carotid artery, and left subclavian artery and their branching ostia positions were quantified. Three-dimensional translation of vessel ostia, branching angles, and their changes secondary to cardiac pulsation and respiration were computed.
  
  
  RESULTS
  During expiration, all ostia translated rightward from systole to diastole (P < .035). Regardless of cardiac phase, all ostia translated posteriorly and superiorly from inspiration to expiration (P < .05). Respiration induced greater posterior and superior translations than cardiac pulsation (P < .03). The left common carotid artery branch angled significantly more toward the aortic arch compared with the brachiocephalic artery and left subclavian artery (P < .03). No significant changes in branching angle were found from systole to diastole or inspiration to expiration.
  
  
  CONCLUSIONS
  In patients with thoracic aortic aneurysms or dissections, the thoracic aortic arch translated significantly secondary to inspiration and expiration and to a lesser extent secondary to cardiac pulsation. Insignificant branching angle changes suggest that the aortic arch and its branch origins move predominantly in unison.
authors: Department of Surgery, Stanford University, 300 Pasteur Drive, Suite H3600, Stanford, CA 94305-5642. Electronic address: gysuh@stanford.edu.
authors: Ga-Young
authors: GY
authors: Suh
authors: Department of Cardiothoracic Surgery, Stanford University, 300 Pasteur Drive, Suite H3600, Stanford, CA 94305-5642.
authors: Ramin E
authors: RE
authors: Beygui
authors: Department of Radiology, Stanford University, 300 Pasteur Drive, Suite H3600, Stanford, CA 94305-5642.
authors: Dominik
authors: D
authors: Fleischmann
authors: Department of Surgery, Stanford University, 300 Pasteur Drive, Suite H3600, Stanford, CA 94305-5642.
authors: Christopher P
authors: CP
authors: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging*; D062485:Breath Holding; D004562:Electrocardiography / Q000379:methods; D045853:Exhalation / Q000502:physiology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods