Computational Fluid Dynamics Simulations to Predict False Lumen Enlargement After Surgical Repair of Type-A Aortic Dissection
| Autor: | Rohan Shad, Robyn Fong, Nicolas Quach, Cayley Bowles, Anson M. Lee, Sandra Kong, Patpilai Kasinpila, William Hiesinger |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pulsatile flow Hemodynamics Lumen (anatomy) 030204 cardiovascular system & hematology 03 medical and health sciences Blood Vessel Prosthesis Implantation 0302 clinical medicine Interquartile range Internal medicine Medicine Humans Retrospective Studies Aortic dissection Cardiac cycle Aortic Aneurysm Thoracic business.industry Endovascular Procedures Models Cardiovascular General Medicine medicine.disease Aortic Aneurysm Aortic Dissection Blood pressure Treatment Outcome 030228 respiratory system Flow velocity Cardiology Hydrodynamics Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Seminars in thoracic and cardiovascular surgery. 34(2) |
| ISSN: | 1532-9488 |
| Popis: | We aim to use computational fluid dynamics to investigate the hemodynamic conditions that may predispose to false lumen enlargement in this patient population. Nine patients who received surgical repairs of their type-A aortic dissections between 2017–2018 were retrospectively identified. Multiple contrast-enhanced post-operative CT scans were used to construct 3D models of aortic geometries. Computational fluid dynamics simulations of the models were run on a high-performance computing cluster using SimVascular – an open-source simulation package. Physiological pulsatile flow conditions (4.9 L/min) were used at the aortic true lumen inlet, and physiological vascular resistances were applied at the distal vascular ends. Exploratory analyses showed no correlation between rate of false lumen growth and blood pressure, immediate post-op aortic diameter, or the number of fenestrations (p = 0.2). 1-year post-operative CT scans showed a median false lumen growth rate of 4.31 (3.66, 14.67) mm/year Median (Interquartile range) peak systolic, mid-diastolic, and late diastolic velocity magnitudes were 0.90 (1.40); 0.10 (0.16); and 0.06 (0.06) cm/s respectively. Spearman's ranked correlations between fenestration velocity and 1-year false lumen growth rates were found to be statistically significant: Velocity magnitude at peak systolic (p = 0.025; rho = 0.75), mid diastolic (p = 0.025; rho = 0.75) and late diastolic phases of the cardiac cycle (p = 0.006; rho = 0.85). We have shown that false lumen growth is strongly correlated to fenestration flow velocity, which has potential implications for post-operative surveillance and risk stratification. |
| Databáze: | OpenAIRE |
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