title: Role of regional aortic wall properties in the pathogenesis of thoracic aortic dissection.
abstract: OBJECTIVE
  The mechanisms of the location and extension of acute aortic dissection (AD) are only poorly understood. The aim of this study was to compare the cohesion of the non-coronary aortic sinus (NAS) and the ascending aortic wall (AA) using the Dissectometer - a new device for analyses of the mechanical properties of the aorta.
  
  
  METHODS
  The properties of the aortic wall were analyzed with the "Dissectometer" (parameters P7, P8 and P9) in adult patients undergoing aortic root (AR) replacement in two different segments: NAS and AA. The aortic wall thickness (AWT) was measured with a micrometer.
  
  
  RESULTS
  Thirty-three adult patients (mean age 65 ± 14 years, 80% male) were included in this study. The aortic wall of the NAS was significantly thinner than that of the AA (1.9 ± 0.4 vs. 2.3 ± 0.4, p < 0.01). In contrast, mechanical stability assessed by cohesion testing was diminished in AA samples compared to NAS samples (P7: 86.0 ± 55.0 vs. 152.3 ± 89.2, p < 0.01; P8: 2.5 ± 1.3 vs. 6.0 ± 3.1, p < 0.01; P9: 3.6 ± 1.4 vs. 7.8 ± 3.2, p < 0.01).
  
  
  CONCLUSIONS
  This study shows that the wall of the AR is characterized by a thin but stable wall, whereas AA was found to be weaker despite its greater thickness. This difference might be involved in the development and spreading of aortic dissections.
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , West German Heart and Vascular Center Essen, University Hospital of Essen , Essen , Germany.
authors.forename: Lisa
authors.initials: L
authors.lastname: Himpel
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , West German Heart and Vascular Center Essen, University Hospital of Essen , Essen , Germany.|b Department of Intensive Care Medicine , Imland Klinik Rendsburg , Rendsburg , Germany.
authors.forename: Kevin
authors.initials: K
authors.lastname: Pilarczyk
authors.affiliation: c Mehr als Durchschnitt Statistikberatung , Mühlheim an der Ruhr , Germany.
authors.forename: Aziz
authors.initials: A
authors.lastname: Wahbi
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , West German Heart and Vascular Center Essen, University Hospital of Essen , Essen , Germany.
authors.forename: Fanar
authors.initials: F
authors.lastname: Mourad
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , West German Heart and Vascular Center Essen, University Hospital of Essen , Essen , Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tsagakis
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , West German Heart and Vascular Center Essen, University Hospital of Essen , Essen , Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Jakob
authors.affiliation: a Department of Thoracic and Cardiovascular Surgery , West German Heart and Vascular Center Essen, University Hospital of Essen , Essen , Germany.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Benedik
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001011:Aorta / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D019719:Diagnostic Equipment; D004108:Dilatation, Pathologic; D004867:Equipment Design; D005260:Female; D005858:Germany; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013718:Tensile Strength
keywords: Aortic wall; aortic dissection; dissectometer