In Vitro Characterisation of Physiological and Maximum Elastic Modulus of Ascending Thoracic Aortic Aneurysms Using Uniaxial Tensile Testing

Objective: Ascending thoracic aortic aneurysms (ATAA) are a life-threatening condition due to the risk of rupture or dissection. This risk is increased in the presence of a bicuspid aortic valve (BAV). The purpose of this study was to provide data on the elastic modulus of aortic wall of ATAA using uniaxial tensile testing in two different areas of the stress-strain relationship: physiological and maximum range of stresses. The influence of tissue location, tissue orientation and valve type on these parameters was investigated. Materials and methods: Tissues freshly excised from ATAA with bicuspid or tricuspid aortic valve were obtained from greater and lesser curvature (GC and LC) and the specimens were tested uniaxially in circumferential (CIRC) and longitudinal (LONG) orientation. Maximum elastic modulus (MEM) was given by the maximum slope of the stress-strain curve before failure. Physiological modulus (PM) was derived from the Laplace law and from ranges of pressure of 80-120 mmHg. Means of each group of specimen were compared using Student's t-test to assess the influence of location, orientation and valve type on each mechanical parameter. Results: PM was found to be significantly lower than the MEM (p < 0.001). The MEM and PM were significantly higher (p < 0.01) in the CIRC (n = 66) than in the LONG orientation (n = 42). The MEM was higher in the circumferential orientation in the BAV group (p < 0.001 in GC and p < 0.05 in LC). MEM and PM in GC specimens were higher in the longitudinal orientation than the LC specimens (p < 0.05). Conclusion: This study demonstrates the anisotropy of the aortic wall in ATAA and provides data on the mechanical behaviour in the physiological range of pressure. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.