title: The Impact of Intimal Tear Location and Partial False Lumen Thrombosis in Acute Type B Aortic Dissection.
abstract: BACKGROUND
  Partial false lumen (FL) thrombosis is a risk factor for long-term mortality in acute type B aortic dissection (ATBAD). This study investigates FL pressures in models of ATBAD with patent and partially thrombosed FL.
  
  
  METHODS
  Twenty-five porcine aortas were used to create five models of ATBAD that were connected to a pulsatile flow loop. Models A through C had a patent FL with the following morphologies: model A, single proximal tear; model B, single distal tear; and model C, single proximal and single distal tear. Models D and E had a single proximal and a single distal tear, with partial FL thrombosis. Model D had FL occlusion of the proximal tear, and model D had FL occlusion of the distal tear. True lumen (TL) and FL pressures were measured at 90 to 150 mm Hg.
  
  
  RESULTS
  In model A, FL pressures were 6 mm Hg higher than TL pressures (p < 0.01). In model B, FL pressures were 10 mm Hg lower than TL pressures (p ≤ 0.01). In model C, TL and FL pressures were equivalent. In model D, FL pressures were 40 mm Hg lower than TL pressures (p < 0.001). In model E, FL pressures were 10 mm Hg higher than TL pressures (p < 0.01).
  
  
  CONCLUSIONS
  In a biologic model of ATBAD, the number, location, and FL thrombosis status determine FL pressure. In the setting of partial FL thrombosis, the FL pressure is reduced with proximal tear occlusion and increased with distal tear occlusion. Reduced FL pressure is related to retrograde flow.
authors.affiliation: Structural Heart Research and Innovation Laboratory and Division of Cardiothoracic Surgery and Carlyle Fraser Heart Center, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Apoorva
authors.initials: A
authors.lastname: Girish
authors.affiliation: Structural Heart Research and Innovation Laboratory and Division of Cardiothoracic Surgery and Carlyle Fraser Heart Center, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Muralidhar
authors.initials: M
authors.lastname: Padala
authors.affiliation: Structural Heart Research and Innovation Laboratory and Division of Cardiothoracic Surgery and Carlyle Fraser Heart Center, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Kanika
authors.initials: K
authors.lastname: Kalra
authors.affiliation: Structural Heart Research and Innovation Laboratory and Division of Cardiothoracic Surgery and Carlyle Fraser Heart Center, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Bryant V
authors.initials: BV
authors.lastname: McIver
authors.affiliation: Division of Vascular and Endovascular Therapy, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Veeraswamy
authors.affiliation: Division of Cardiothoracic Surgery, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Chen
authors.affiliation: Division of Cardiothoracic Surgery, Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia. Electronic address: bleshno@emory.edu.
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Leshnower
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000473:pathology / Q000503:physiopathology*; D000818:Animals; D001011:Aorta / Q000473:pathology*; D001014:Aortic Aneurysm / Q000473:pathology / Q000503:physiopathology*; D001794:Blood Pressure; D018056:Hemorheology; D066298:In Vitro Techniques; D008955:Models, Cardiovascular; D011673:Pulsatile Flow; D034421:Sus scrofa; D013552:Swine; D013927:Thrombosis / Q000473:pathology*; D017539:Tunica Intima / Q000293:injuries / Q000473:pathology