The importance of collagen composition and biomechanics for the porcine aortic root

A thorough understanding of the aortic root structure and biomechanics is necessary when performing aortic valve-sparing procedures in patients with aortic root aneurysms. This study aimed to evaluate the amount of collagen and biomechanics at different levels and segments of the aortic root. Ten ao...

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Bibliographic Details
Published in:Journal of biomechanics 2020-10, Vol.111, p.110009-110009, Article 110009
Main Authors: Salvig, Camilla D., Benhassen, Leila L., Nygaard, Jens V., Johansen, Peter, Skov, Søren N., Michael Hasenkam, J.
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Animals
Annuli
Aorta
Aortic valve
Aortic Valve - surgery
Aortic Valve Insufficiency
Biomechanical aortic root characterization
Biomechanical engineering
Biomechanical Phenomena
Biomechanics
Collagen
Collagen content
Heart valves
Humans
Hydroxyproline
Investigations
Mechanical properties
Porcine aortic root
Segments
Sinus of Valsalva - surgery
Sinuses
Statistical analysis
Stiffness
Surgery
Swine
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Summary:A thorough understanding of the aortic root structure and biomechanics is necessary when performing aortic valve-sparing procedures in patients with aortic root aneurysms. This study aimed to evaluate the amount of collagen and biomechanics at different levels and segments of the aortic root. Ten aortic roots from healthy pigs were excised including the aortic annulus, the sinuses of Valsalva, and the sinotubular junction (STJ). Specimens were further divided into three circumferential segments; left coronary (LC)-, right coronary (RC)-, and non-coronary (NC) sinus. Collagen was determined using hydroxyproline analysis and specimens were tested biomechanically for stress–strain relations. The annulus showed significantly larger average maximum stiffness (9.6 ± 4.5 N/mm) compared with the sinus (4.5 ± 2.0 N/mm) and STJ (4.8 ± 1.8 N/mm). The average collagen content was likewise higher in the annulus (4.0 ± 1.0 mg/ml) compared with the sinus (2.4 ± 0.6 mg/ml) and STJ (2.2 ± 0.5 mg/ml) for all three segments. The NC sinus segment exhibited a significantly larger maximum stiffness and stress under static conditions compared with the RC. These results suggest that the aortic root is heterogeneous in both structure and biomechanical properties and that it varies both in levels and segments of the aortic root. Future surgical approaches should consider enhanced strength parameters for specific areas of the aortic root to achieve the best results when performing aortic valve-sparing techniques. From this study, we conclude that the aortic annulus needs special attention to imitate normal physiologic properties during aortic valve-sparing surgery due to its higher maximum stiffness, stress, and load. Modified future surgical procedures could potentially prevent recurrent aneurysmal formation.
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2020.110009