Old Myths, New Concerns: the Long-Term Effects of Ascending Aorta Replacement with Dacron Grafts. Not All That Glitters Is Gold.
Old Myths, New Concerns: the Long-Term Effects of Ascending Aorta Replacement with Dacron Grafts. Not All That Glitters Is Gold.
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DOI：
10.1007/s12265-016-9699-8
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发表时间：
2016-08
影响因子：
3.4
通讯作者：
Rainer A
中科院分区：
文献类型：
--
作者：
Spadaccio C;Nappi F;Al-Attar N;Sutherland FW;Acar C;Nenna A;Trombetta M;Chello M;Rainer A
自20世纪70年代中期以来，合成移植物广泛用于心脏和血管手术。尽管它们的总体性能良好，但无法模仿天然动脉组织的血管力学特性，以及随之而来的缺乏足够的顺应性，导致血液动力学和生物学改变的级联，深深影响心血管稳态。这些问题已被重新考虑，在更同期的手术和实验报告，也引发了一些研究工作，在组织工程领域的仿生动脉替代品的实现。本文综述了主动脉根部或升主动脉人工血管置换术后出现的“顺应性不匹配”现象的意义，并讨论了这种组织不相容状态的临床反映，因为主动脉的天然血管机械特性的损失可以转化为对主动脉根复合体的正常效率的有害影响，接受主动脉置换术患者的长期结果。
Synthetic grafts are widely used in cardiac and vascular surgery since the mid-1970s. Despite their general good performance, inability of mimicking the elastomechanical characteristics of the native arterial tissue, and the consequent lack of adequate compliance, leads to a cascade of hemodynamic and biological alterations deeply affecting cardiovascular homeostasis. Those concerns have been reconsidered in more contemporaneous surgical and experimental reports which also triggered some research efforts in the tissue engineering field towards the realization of biomimetic arterial surrogates. The present review focuses on the significance of the “compliance mismatch” phenomenon occurring after aortic root or ascending aorta replacement with prosthetic grafts and discusses the clinical reflexes of this state of tissue incompatibility, as the loss of the native elastomechanical properties of the aorta can translate into detrimental effects on the normal efficiency of the aortic root complex with impact in the long-term results of patients undergoing aortic replacement.