Investigation of hemodynamics in the development of dissecting aneurysm within patient-specific dissecting aneurismal aortas using computational fluid dynamics (CFD) simulations

Tse, Kwong Ming; Chiu, Peixuan; Lee, Heow Pueh; Ho, Pei

doi:10.1016/j.jbiomech.2010.12.014

Cited by 196 publications

(182 citation statements)

References 41 publications

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“…The circumferential component of such stress might be the cleavage force to separate the layers of the aortic wall, and therefore accounts for the distal progression to the visceral segment of the aorta. Similar results have been demonstrated in the study by Tse et al [10]. …”

Section: Discussionsupporting

confidence: 93%

A Pilot Study Exploring the Mechanisms Involved in the Longitudinal Propagation of Acute Aortic Dissection through Computational Fluid Dynamic Analysis

Zhang¹,

Lu²,

Feng³

et al. 2014

Cardiology

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Objective: This study sought to elucidate the underlying hemodynamic mechanisms involved in the longitudinal propagation of acute, type-B aortic dissections. Methods: Three-dimensional patient-specific aortic geometry was reconstructed from computed tomography images of 3 cases, followed by computational fluid dynamic analysis using finite-element analysis modeling. Three models were reconstructed; the normal-aortic model (from a healthy volunteer), the visceral-involvement model (from a patient whose visceral arteries were involved) and the progression model (from a patient whose visceral arteries were intact at admission). Wall pressure distribution was analyzed in all three models. Results: In the systolic phase of a cardiac cycle, the wall pressure dropped from the proximal to the distal aorta within the true lumen. This pressure gradient was observed in all three models. A milder pressure gradient was seen in the false lumen in the visceral-involvement model, whereas the pressure in the false lumen remained almost constant in the progression model. The dyssynchrony of the pressure gradients in the true and false lumens caused an imbalance in pressure between the two lumens. Conclusion: The interluminal pressure differential may be a contributing factor in the compression of the true lumen and the cleavage force of the aortic wall, leading to the longitudinal propagation of the dissection.

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Section: Discussionsupporting

confidence: 93%

A Pilot Study Exploring the Mechanisms Involved in the Longitudinal Propagation of Acute Aortic Dissection through Computational Fluid Dynamic Analysis

Zhang¹,

Lu²,

Feng³

et al. 2014

Cardiology

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“…Altered fluid dynamics were shown to influence the development of dissection, whereas high WSSs were associated with tear initiation and propagation [58].…”

Section: Fluid Mechanics Analysismentioning

confidence: 99%

Is There a Role for Biomechanical Engineering in Helping to Elucidate the Risk Profile of the Thoracic Aorta?

Martufi

Forneris

Appoo

et al. 2016

The Annals of Thoracic Surgery

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“…However, the computational mesh used in all these reports does not have a refined boundary layer and uses very low numbers of tetrahedral elements throughout the computational domain (~264,000-388,000 elements). Likewise, the work of Tse et al 89 who investigated a pre and post-aneurysmal dissection case also employ a coarse mesh (84,209 and 114,148 elements) without a refined boundary layer. Refinement of the mesh in the boundary layer is critical and was shown to change the resulting velocity, pressure and WSS by 9, 30 and 24%, respectively.…”

Section: Variations In Modelling Approachmentioning

confidence: 99%

Computational Biomechanics in Thoracic Aortic Dissection: Today’s Approaches and Tomorrow’s Opportunities

Doyle

Norman

2015

Ann Biomed Eng

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Dissection of an artery is characterised by the separation of the layers of the arterial wall causing blood to flow within the wall. The incidence rates of thoracic aortic dissection (AoD) are increasing, despite falls in virtually all other manifestations of cardiovascular disease, including abdominal aortic aneurysm (AAA). Dissections involving the ascending aorta (Type A) are a medical emergency and require urgent surgical repair. However, dissections of the descending aorta (Type B) are less lethal and require different clinical management whereby the patient may not be offered surgery unless complicating factors are present. But how do we tell if a patient will develop a complication later on? Currently, there is no consensus and the evidence base is limited. There is an opportunity for computational biomechanics to help clinicians decide as to which cases to repair and which to manage with blood pressure control. In this review article, we look at AoD from both the clinical and biomechanical perspective and discuss some of the recent computational studies of both Type A and B AoD. We then focus more on Type B where the real opportunity for patient-specific modelling exists. Finally, we look ahead at some of the promising areas of research that may help clinicians improve the decision-making process surrounding Type B AoD.

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Investigation of hemodynamics in the development of dissecting aneurysm within patient-specific dissecting aneurismal aortas using computational fluid dynamics (CFD) simulations

Cited by 196 publications

References 41 publications

A Pilot Study Exploring the Mechanisms Involved in the Longitudinal Propagation of Acute Aortic Dissection through Computational Fluid Dynamic Analysis

A Pilot Study Exploring the Mechanisms Involved in the Longitudinal Propagation of Acute Aortic Dissection through Computational Fluid Dynamic Analysis

Is There a Role for Biomechanical Engineering in Helping to Elucidate the Risk Profile of the Thoracic Aorta?

Computational Biomechanics in Thoracic Aortic Dissection: Today’s Approaches and Tomorrow’s Opportunities

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