HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): David L.S. Morales Jacquelyn A. Quin John H. Braxton Graeme L. Hammond John A. Elefteriades Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Morales, D. L.S. Articles by Elefteriades, J. A. Search for Related Content PubMed PubMed Citation Articles by Morales, D. L.S. Articles by Elefteriades, J. A.

Ann Thorac Surg 1998;66:1679-1683
© 1998 The Society of Thoracic Surgeons

Experimental confirmation of effectiveness of fenestration in acute aortic dissection

^a Section of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, Connecticut, USA

Accepted for publication May 27, 1998.

Address reprint requests to Dr Elefteriades, Section of Cardiothoracic Surgery, Yale University School of Medicine, 121 FMB, 333 Cedar Street, New Haven, CT 06520
e-mail: (John Elefteriades{at}qm.yale.edu)

Background. Aortic fenestration is used clinically to treat organ ischemia in acute descending aortic dissection. However, fenestration has not been studied experimentally. This study does so using an animal model.

Methods. Descending aortic dissection was created in six dogs, with subsequent fenestration of the infrarenal aorta. Blood flow (femoral, cephalic, and renal), blood pressure (femoral and carotid), and aortic distensibility were measured at baseline, after dissection, and after fenestration. Values were compared using paired t tests.

Results. Baseline femoral, cephalic, and renal arterial flows were 53 ± 37, 78 ± 65, and 83 ± 52 mL/min, respectively. Baseline femoral and carotid pressures were 82 ± 13 and 81 ± 11 mm Hg, respectively. After dissection, femoral, cephalic, and renal arterial flow decreased to 20 ± 21 (p < 0.05), 38 ± 26, and 56 ± 36 mL/min, respectively. Femoral blood pressure decreased to 28 ± 17 mm Hg (p < 0.05). With fenestration, femoral, cephalic, and renal flows increased to 60 ± 37 (p < 0.05), 78 ± 51, and 80 ± 48 mL/min, respectively. Femoral blood pressure increased to 85 ± 28 mm Hg (p < 0.05). Carotid pressure remained unchanged with dissection and fenestration (77 ± 17 mm Hg, 82 ± 17 mm Hg, respectively). Baseline aortic distensibility (21%) decreased significantly after dissection (to 1.4%, p < 0.05) and increased after fenestration (to 12%, p < 0.05).

Conclusions. Experimental aortic fenestration restored blood pressure and flow to hypoperfused organs in acute descending aortic dissection. The continued clinical application of fenestration is supported.

This article has been cited by other articles:

				X.-X. Li, S.-M. Wang, W. Chen, W.-Q. Zhuang, Z.-H. Wu, G.-Q. Chang, S.-Q. Li, J.-Y. Yang, and Y.-J. Lin Endovascular Stent-Graft Repair of Aortic Dissection Asian Cardiovasc Thorac Ann, June 1, 2004; 12(2): 99 - 102. [Abstract] [Full Text] [PDF]