Rapid evaporative ionization mass spectrometry (intelligent knife) for point-of-care testing in acute aortic dissection surgery

Davies, Hannah A, Caamano-Gutierrez, Eva ORCID: 0000-0001-7737-5941, Sarsby, Joscelyn, Chim, Ya Hua, Barrett, Steve ORCID: 0000-0003-2960-3334, Nawaytou, Omar, Harky, Amer ORCID: 0000-0001-5507-5841, Field, Mark, Akhtar, Riaz ORCID: 0000-0002-7963-6874 and Madine, Jillian ORCID: 0000-0001-9963-5871 (2022) Rapid evaporative ionization mass spectrometry (intelligent knife) for point-of-care testing in acute aortic dissection surgery. Interactive CardioVascular and Thoracic Surgery, 34 (5). pp. 833-840.

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Official URL: http://dx.doi.org/10.1093/icvts/ivac019

Abstract

<jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>Rapid evaporative ionization mass spectrometry (REIMS) can discriminate aneurysmal from normal aortic tissue. Our objective in this work was to probe the integrity of acute dissection tissue using biomechanical, biochemical and histological techniques and demonstrate that REIMS can be used to discriminate identified differences.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Human aortic tissue was obtained from patients undergoing surgery for acute aortic dissection. Biomechanical, biochemical and histological assessment was carried out to probe mechanical properties and elastin, collagen and glycosaminoglycan composition of the tissue. Monopolar electrocautery was applied to samples and surgical aerosol aspirated and analysed by REIMS to produce mass spectral data.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Tissue was obtained from 10 patients giving rise to 26 tissue pieces: 10 false lumen (FL), 10 dissection flap and 6 true lumen samples. Models generated from biomechanical and biochemical data showed that FL tissue was distinct from true lumen and dissection flap tissue. REIMS identified the same pattern being able to classify tissue types with 72.4% accuracy and 69.3% precision. Further analysis of REIMS data for FL tissue suggested patients formed 3 distinct clusters. Histological and biochemical assessment revealed patterns of extracellular matrix degradation within the clusters that are associated with altered tissue integrity identified using biomechanical testing.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Structural integrity of the FL in acute Type A dissection could dictate future clinical distal disease progression. REIMS can detect differences in tissue integrity, supporting its development as a point-of-care test to guide surgical intraoperative decision-making.</jats:p> </jats:sec>

Item Type:	Article
Uncontrolled Keywords:	Acute aortic dissection, Rapid evaporative ionization mass spectrometry, Biomechanics, Biochemistry, Tissue integrity, False lumen
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology Faculty of Health and Life Sciences > Tech, Infrastructure and Environmental Directorate Faculty of Science and Engineering > School of Engineering
Depositing User:	Symplectic Admin
Date Deposited:	04 Feb 2022 09:47
Last Modified:	18 Jan 2023 21:14
DOI:	10.1093/icvts/ivac019
Open Access URL:	https://doi.org/10.1093/icvts/ivac019
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3148184