Key result
Ascending aortic repair is linked to markedly reduced regional strain and increased aortic stiffness.
Why the study?
The study aimed to evaluate intrasegmental and intersegmental thoracic aortic biomechanics in patients with ascending aortic aneurysms before and after thoracic aortic repair using aortic wall ultrasound assessment.
Does ascending aortic hemiarch repair alter thoracic aortic biomechanics (circumferential strain and aortic wall stiffness) in patients with ascending aortic aneurysms?
Observational (n=23)
Does ascending aortic hemiarch repair alter thoracic aortic biomechanics (circumferential strain and aortic wall stiffness) in patients with ascending aortic aneurysms?
Answers are grounded in this paper and cite their sources.
Ascending aortic repair creates a new biomechanical phenotype characterized by an intersegmental imbalance of strain and increased stiffness in the repaired area compared to the native aortic root, arch, and descending aorta.
Aim. Intrasegmental and intersegmental analysis of thoracic aortic (TA) biomechanics in patients with ascending aortic (AA) aneurysms before and after TA repair using aortic wall ultrasound assessment. Material and methods. Twenty-three patients with AA aneurysms (≥50 mm) were examined. Eleven (48%) patients had connective tissue dysplasia. All patients underwent 2D multiplane transesophageal echocardiography with the entire TA imaging before and after TA repair. Using 2D speckle-tracking technology, we calculated global peak systolic circumferential strain (GCS, %), GCS normalized to pulse pressure (PP) (GCS/PP), and the β 2 aortic wall stiffness index in following three TA segments: sinuses of Valsalva, mid AA segment, and descending aorta (DA). Results. In patients with AA aneurysm, before surgery, a significant decrease in strain and increase in stiffness of the aortic wall in the direction from the aortic root to the DA with a maximum in the area of greatest dilation — the middle AA segment (GCS: -1,1% [-2,4; 2,9], p<0,001; GCS/PP: -2,4 [-4,2; 2,9], p<0,001; β 2 : 24 [15,7; 32,6], p<0,001). In 13 (56%) patients, intersegmental multidirectional strain was detected along the aortic wall circumference in the aortic root, AA and DA. After AA replacement, multidirectional intrasegmental and intersegmental changes of the aortic wall strain and stiffness were revealed. In the intersegmental analysis, significant lowest values of strain indices and highest values of aortic wall stiffness were detected in the AA repair area (GCS: 1,1% [-3,2; 2,2], p<0,001; GCS/PP: 1,6 [-4,4; 2,8], p<0,001; β 2 : 33,5 [15,1; 50,2], p<0,01). Conclusion. AA aneurysm is accompanied by a pronounced limitation of strain and an increase in aortic wall stiffness with a maximum in the greatest dilation area — the middle AA segment. AA repair creates a new biomechanical phenotype of the TA, manifested by an intersegmental imbalance of strain and aortic wall stiffness between the aortic root, the repair area AA and the arch, and DA.
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Vrublevsky et al. (2026) conducted an observational in Ascending aortic aneurysms (≥50 mm) (n=23). Ascending aortic hemiarch repair vs. Preoperative baseline (before thoracic aortic repair) was evaluated on Global peak systolic circumferential strain (GCS), GCS normalized to pulse pressure (GCS/PP), and β2 aortic wall stiffness index in the ascending aorta repair area (p=<0.001). Ascending aortic repair resulted in lowest strain and highest stiffness in the repair area (GCS 1.1% vs -1.1% pre-op, p<0.001; β2 stiffness 33.5, p<0.01).
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