Ex-vivo Haemodynamic Models for the Study of Stanford Type B Aortic Dissection in Isolated Porcine Aorta

Qing K-X, Chan YC, Lau SF, et al (The Univ of Hong Kong, Pokfulam Road) Eur J Vasc Endovasc Surg 44:399-405, 2012^§

Abstract

Objectives

The aim of this study is to present novel ex-vivo models in the study of complex haemodynamical changes in Stanford type B aortic dissection (TBAD).

Materials and Methods

Fifteen fresh porcine aortas were harvested and preserved with 4°C saline. Ex-vivo models were developed to simulate TBAD in three different situations: model A with patent false lumen, model B with distal re-entry only and model C with proximal primary entry only. These models were connected to standardised pulsatile pumps and the pressure waveforms were monitored and compared. The aortas were scanned with ultrasonography and subjected to post-experiment autopsy.

Results

The three different models were successfully created (n = 13). Pulsatile flow testing was successful and the shapes of the pressure waveforms were similar to those taken from human aorta. Post-testing gross examination confirmed the success of modelling.

Conclusion

Porcine aortas may prove to be useful ex-vivo models in the study of aortic dissection haemodynamics. These models are reproducible and may be used in the study of complex haemodynamic forces during the development and propagation of TBAD. Our three porcine models give a potential possibility in helping clinicians isolate and analyse complex haemodynamical factors in the development, propagation and prognosis of TBAD (Figs 3 and 6).

Figure 3 Procedure of creating model A. A: using a 20-GA I.V. catheter puncture intima on a turned over aorta. B: creating a bleb with blood-stained saline. C: channelling the dissection flap. D: cutting the dissecting flap to create a primary entry in a proximal location with scissors. E: creating a re-entry on the distal portion of dissecting flap with scissors. (Reprinted from European Journal of Vascular and Endovascular Surgery. Qing K-X, Chan YC, Lau SF, et al. Ex-vivo haemodynamic models for the study of Stanford type B aortic dissection in isolated porcine aorta. Eur J Vasc Endovasc Surg. 2012;44:399-405, Copyright 2012, with permission from European Society for Vascular Surgery.)

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