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A patient-specific study of type-B aortic dissection: evaluation of true-false lumen blood exchange.

Chen D, Müller-Eschner M, von Tengg-Kobligk H, Barber D, Böckler D, Hose R, Ventikos Y - Biomed Eng Online (2013)

Bottom Line: Loading distributions including pressure and wall shear stress have also been investigated and results of direct simulations are compared with solutions employing appropriate turbulence models.This contributes to evaluating potential thrombotic behavior in the false lumen and is pivotal in guiding endovascular intervention.Moreover, as a computational study, mesh requirements to successfully evaluate the hemodynamic parameters have been proposed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China. duanduan@bit.edu.cn

ABSTRACT

Background: Aortic dissection is a severe pathological condition in which blood penetrates between layers of the aortic wall and creates a duplicate channel - the false lumen. This considerable change on the aortic morphology alters hemodynamic features dramatically and, in the case of rupture, induces markedly high rates of morbidity and mortality.

Methods: In this study, we establish a patient-specific computational model and simulate the pulsatile blood flow within the dissected aorta. The k-ω SST turbulence model is employed to represent the flow and finite volume method is applied for numerical solutions. Our emphasis is on flow exchange between true and false lumen during the cardiac cycle and on quantifying the flow across specific passages. Loading distributions including pressure and wall shear stress have also been investigated and results of direct simulations are compared with solutions employing appropriate turbulence models.

Results: Our results indicate that (i) high velocities occur at the periphery of the entries; (ii) for the case studied, approximately 40% of the blood flow passes the false lumen during a heartbeat cycle; (iii) higher pressures are found at the outer wall of the dissection, which may induce further dilation of the pseudo-lumen; (iv) highest wall shear stresses occur around the entries, perhaps indicating the vulnerability of this region to further splitting; and (v) laminar simulations with adequately fine mesh resolutions, especially refined near the walls, can capture similar flow patterns to the (coarser mesh) turbulent results, although the absolute magnitudes computed are in general smaller.

Conclusions: The patient-specific model of aortic dissection provides detailed flow information of blood transport within the true and false lumen and quantifies the loading distributions over the aorta and dissection walls. This contributes to evaluating potential thrombotic behavior in the false lumen and is pivotal in guiding endovascular intervention. Moreover, as a computational study, mesh requirements to successfully evaluate the hemodynamic parameters have been proposed.

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Related in: MedlinePlus

Wall shear stress distribution of the aortic dissection system. The left panel shows the results at systolic peak; and the right panel displays the results at mid-diastole.
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Figure 9: Wall shear stress distribution of the aortic dissection system. The left panel shows the results at systolic peak; and the right panel displays the results at mid-diastole.

Mentions: Figure 9 represents the wall shear stress (WSS) distribution for the case studied. During systole, the dissected aorta system experiences very high WSS that is up to 89 Pa; while, during diastole, the WSS becomes much lower: the maximum WSS over this period is approximately 5 Pa. The highest WSS occurs near the entries, implicating the vulnerability of these positions to be further split; in fact, by decreasing the arterial shear stress, one can minimize the propagation of the dissection [43,44].


A patient-specific study of type-B aortic dissection: evaluation of true-false lumen blood exchange.

Chen D, Müller-Eschner M, von Tengg-Kobligk H, Barber D, Böckler D, Hose R, Ventikos Y - Biomed Eng Online (2013)

Wall shear stress distribution of the aortic dissection system. The left panel shows the results at systolic peak; and the right panel displays the results at mid-diastole.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3734007&req=5

Figure 9: Wall shear stress distribution of the aortic dissection system. The left panel shows the results at systolic peak; and the right panel displays the results at mid-diastole.
Mentions: Figure 9 represents the wall shear stress (WSS) distribution for the case studied. During systole, the dissected aorta system experiences very high WSS that is up to 89 Pa; while, during diastole, the WSS becomes much lower: the maximum WSS over this period is approximately 5 Pa. The highest WSS occurs near the entries, implicating the vulnerability of these positions to be further split; in fact, by decreasing the arterial shear stress, one can minimize the propagation of the dissection [43,44].

Bottom Line: Loading distributions including pressure and wall shear stress have also been investigated and results of direct simulations are compared with solutions employing appropriate turbulence models.This contributes to evaluating potential thrombotic behavior in the false lumen and is pivotal in guiding endovascular intervention.Moreover, as a computational study, mesh requirements to successfully evaluate the hemodynamic parameters have been proposed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China. duanduan@bit.edu.cn

ABSTRACT

Background: Aortic dissection is a severe pathological condition in which blood penetrates between layers of the aortic wall and creates a duplicate channel - the false lumen. This considerable change on the aortic morphology alters hemodynamic features dramatically and, in the case of rupture, induces markedly high rates of morbidity and mortality.

Methods: In this study, we establish a patient-specific computational model and simulate the pulsatile blood flow within the dissected aorta. The k-ω SST turbulence model is employed to represent the flow and finite volume method is applied for numerical solutions. Our emphasis is on flow exchange between true and false lumen during the cardiac cycle and on quantifying the flow across specific passages. Loading distributions including pressure and wall shear stress have also been investigated and results of direct simulations are compared with solutions employing appropriate turbulence models.

Results: Our results indicate that (i) high velocities occur at the periphery of the entries; (ii) for the case studied, approximately 40% of the blood flow passes the false lumen during a heartbeat cycle; (iii) higher pressures are found at the outer wall of the dissection, which may induce further dilation of the pseudo-lumen; (iv) highest wall shear stresses occur around the entries, perhaps indicating the vulnerability of this region to further splitting; and (v) laminar simulations with adequately fine mesh resolutions, especially refined near the walls, can capture similar flow patterns to the (coarser mesh) turbulent results, although the absolute magnitudes computed are in general smaller.

Conclusions: The patient-specific model of aortic dissection provides detailed flow information of blood transport within the true and false lumen and quantifies the loading distributions over the aorta and dissection walls. This contributes to evaluating potential thrombotic behavior in the false lumen and is pivotal in guiding endovascular intervention. Moreover, as a computational study, mesh requirements to successfully evaluate the hemodynamic parameters have been proposed.

Show MeSH
Related in: MedlinePlus