Most cited article - PubMed ID 25700260
Constitutive modeling of human saphenous veins at overloading pressures
INTRODUCTION: This study examines the mechanical properties of thoracic aortic false aneurysms (TAFA) and how the use of vascular prostheses, native vessels, and anastomoses affects their development. This is done through tensile testing, simulating a Bentall procedure, which is the most common surgery leading to TAFA development. METHODS: We conducted uniaxial tensile tests on the native right and left coronary arteries from five cadaveric donors. They were anastomosed to two vascular prostheses in the longitudinal and circumferential directions to assess their mechanical responses under load. RESULTS AND DISCUSSION: All anastomosis specimens ruptured on the native vessel side, with no breaches occurring on the prosthesis side. The P2 prosthesis exhibited a mechanical response closer to that of the native vessel compared to the P1 prosthesis. There were no statistically significant differences in wall thickness or mechanical properties between the left and right coronary artery samples, leading to the merging of these groups. The strain of the anastomosis in the longitudinal direction was significantly higher than in the circumferential direction. In both directions, the strain at the onset of rupture was greater than that of the native vessel, with a particularly notable difference in the longitudinal direction. Although there was no significant difference in stress values between the longitudinal and circumferential directions, forces per suture were slightly higher in the circumferential direction. CONCLUSION: Using the "endo-button buttress technique" with a double-layer anastomosis can help distribute the load and reduce stress. An alternative option is to use a Carrel patch to reinforce the connection between the target site and the conduit. Additionally, autologous pericardium can be employed for reinforcement.
- Keywords
- Aortic pseudoaneurysm, Bentall procedure, Coronary arteries, Tensile testing, Thoracic aortic false aneurysm,
- MeSH
- Anastomosis, Surgical MeSH
- Aortic Aneurysm, Thoracic * surgery physiopathology MeSH
- Aorta, Thoracic * surgery physiopathology MeSH
- Blood Vessel Prosthesis * MeSH
- Coronary Vessels surgery physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Stress, Mechanical MeSH
- Cadaver MeSH
- Aneurysm, False * surgery physiopathology MeSH
- Tensile Strength MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION: The aim of this study was to develop a prototype of an artificial blood vessel which has similar mechanical properties to a human saphenous vein graft and to experimentally verify the function of the prosthesis via ovine carotid bypass implantation. MATERIAL AND METHODS: The prototype of an artificial graft prosthesis for low flow was developed and manufactured from a collagenous matrix and reinforcing polyester mesh. We compared the results of both the pressurisation and the mechanical stress evaluation tests of VSM with four types of hybrid vascular graft. The most similar graft (type II) was chosen for the first ovine model implantation. RESULTS: Dominant behavior e.g. mechanical response of VSM graft in plots of circumferential and axial stress during loading is observed in circumferential direction. Average results of used VSM showed area of ideal mechanical response and the properties of artificial blood vessels were fitted into this area. Developed graft remained patent after 161 days of follow up in ovine model. CONCLUSIONS: The mechanical properties of the graft were designed and adjusted to be similar to the behaviour of human saphenous veins. This approach showed promising results and enhanced the final performance of the prosthesis.
