Respiratory Displacement of the Thoracic Aorta: Physiological Phenomenon With Potential Implications for Thoracic Endovascular Repair

Journal Article · Wed Jul 15 04:00:00 EDT 2009 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-009-9553-3· OSTI ID:21428501

Tetzlaff, Ralf ^[1]; Rengier, Fabian ^[2]; Geisbuesch, Philipp ^[3]; Kopp-Schneider, Annette ^[4]; Boeckler, Dittmar ^[3]; Eichinger, Monika ^[1]; Kauczor, Hans-Ulrich ^[2]; Tengg-Kobligk, Hendrik von ^[1]

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1. German Cancer Research Center, Department of Radiology (Germany)
2. University Medical Center Heidelberg, Department of Diagnostic and Interventional Radiology (Germany)
3. University Medical Center Heidelberg, Department of Vascular and Endovascular Surgery (Germany)
4. German Cancer Research Center, Department of Biostatistics (Germany)

The purpose of this study was to assess the magnitude and direction of respiratory displacement of the ascending and descending thoracic aorta during breathing maneuvers. In 11 healthy nonsmokers, dynamic magnetic resonance imaging was performed in transverse orientation at the tracheal bifurcation during maximum expiration and inspiration as well as tidal breathing. The magnitude and direction of aortic displacement was determined relatively to resting respiratory position for the ascending (AA) and descending (DA) aorta. To estimate a respiratory threshold for occurrence of distinct respiratory aortic motion, the latter was related to the underlying change in anterior-posterior thorax diameter. Compound displacement between maximum expiration and inspiration was 24.3 {+-} 6.0 mm for the AA in the left anterior direction and 18.2 {+-} 5.5 mm for the DA in the right anterior direction. The mean respiratory thorax excursion during tidal breathing was 8.9 {+-} 2.8 mm. The respiratory threshold, i.e., the increase in thorax diameter necessary to result in respiratory aortic displacement, was estimated to be 15.7 mm. The data suggest that after a threshold of respiratory thorax excursion is exceeded, respiration is accompanied by significant displacement of the thoracic aorta. Although this threshold may not be reached during tidal breathing in the majority of individuals, segmental differences during forced respiration impact on aortic geometry, may result in additional extrinsic forces on the aortic wall, and may be of significance for aortic prostheses designed for thoracic endovascular aortic repair.

• OSTI ID: 21428501
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 4 Vol. 32; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AORTA
ARTERIES
BIFURCATION
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
CHEST
DIAGNOSTIC TECHNIQUES
NMR IMAGING
ORGANS
REPAIR
RESPIRATION