Predicting Outcome of Aortic Dissection with Patent False Lumen by Computational Flow Analysis

Rinaudo, Antonino; D’Ancona, Giuseppe; Lee, Jake J.; Pilato, Gerlando; Amaducci, Andrea; Baglini, Roberto; Follis, Fabrizio; Pilato, Michele; Pasta, Salvatore

doi:10.1007/s13239-014-0182-x

Cited by 34 publications

(35 citation statements)

References 31 publications

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“…CTA images at both end-diastole and peak systole were segmented using semi-automatic thresholding and region growing techniques, combined with manual editing of masks in commercial software (Mimics v20, Materialize NV, Leuven, Belgium) as described previously [19][20][21][22]. The 3D ATAA models were cut near the brachiocephalic artery, to reduce irrelevant shape variability related to the aortic arch and descending aorta.…”

Section: Segmentation and Anatomical Measurementsmentioning

confidence: 99%

Statistical Shape Analysis of Ascending Thoracic Aortic Aneurysm: Correlation between Shape and Biomechanical Descriptors

Cosentino

Raffa

Gentile

et al. 2020

JPM

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An ascending thoracic aortic aneurysm (ATAA) is a heterogeneous disease showing different patterns of aortic dilatation and valve morphologies, each with distinct clinical course. This study aimed to explore the aortic morphology and the associations between shape and function in a population of ATAA, while further assessing novel risk models of aortic surgery not based on aortic size. Shape variability of n = 106 patients with ATAA and different valve morphologies (i.e., bicuspid versus tricuspid aortic valve) was estimated by statistical shape analysis (SSA) to compute a mean aortic shape and its deformation. Once the computational atlas was built, principal component analysis (PCA) allowed to reduce the complex ATAA anatomy to a few shape modes, which were correlated to shear stress and aortic strain, as determined by computational analysis. Findings demonstrated that shape modes are associated to specific morphological features of aneurysmal aorta as the vessel tortuosity and local bulging of the ATAA. A predictive model, built with principal shape modes of the ATAA wall, achieved better performance in stratifying surgically operated ATAAs versus monitored ATAAs, with respect to a baseline model using the maximum aortic diameter. Using current imaging resources, this study demonstrated the potential of SSA to investigate the association between shape and function in ATAAs, with the goal of developing a personalized approach for the treatment of the severity of aneurysmal aorta.

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Section: Segmentation and Anatomical Measurementsmentioning

confidence: 99%

Statistical Shape Analysis of Ascending Thoracic Aortic Aneurysm: Correlation between Shape and Biomechanical Descriptors

Cosentino

Raffa

Gentile

et al. 2020

JPM

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“…Flow pattern within a type B dissected aorta at peak systole (top models) and mid-diastole (bottom models) reconstructed at initial patient admission (left models) and after four-year follow-up (right models) (fromfig. 2, Rinaudo et al26 ).…”

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confidence: 98%

Role of Computational Modeling in Thoracic Aortic Pathology: A Review

et al. 2014

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Thoracic aortic diseases are life-threatening conditions causing significant mortality and morbidity despite advances in diagnostic and surgical treatments. Computational methods combined with imaging techniques provide quantitative information of disease progression, which may improve clinical treatments and therapeutic strategies for clinical practice. Since hemodynamic and wall mechanics play important roles in the natural history and progression of aortic diseases, we reviewed the potential application of computational modeling of the thoracic aorta. We placed emphasis on the clinical relevance of these techniques for the assessment of aortic dissection, thoracic aortic aneurysm, and aortic coarctation. Current clinical guidelines and treatment are also described.

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“…Volumetric CT images in standard DICOM format were imported in Mimics to reconstruct the left ventricle, left atrium, and aortic root anatomy in terms of the spatial position and dimension by applying different gray values and multiple masks based on different Hounsfield unit thresholds. Segmentation was performed by semi-automatic thresholding operation followed by manual mask editing and morphological operation including cropping, erosion, and smoothing, as done previously by our group [14][15][16][17][18]. The bioprosthetic heart valve was distinctly reconstructed using a different mask.…”

Section: Anatomic Reconstructionmentioning

confidence: 99%

Pre-Operative Modeling of Transcatheter Mitral Valve Replacement in a Surgical Heart Valve Bioprosthesis

Pasta

Gandolfo

2020

Prosthesis

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Obstruction of the left ventricular outflow tract (LVOT) is a common complication of transcatheter mitral valve replacement (TMVR). This procedure can determine an elongation of an LVOT (namely, the neo-LVOT), ultimately portending hemodynamic impairment and patient death. This study aimed to understand the biomechanical implications of LVOT obstruction in a patient who underwent TMVR using a transcatheter heart valve (THV) to repair a failed bioprosthetic heart valve. We first reconstructed the heart anatomy and the bioprosthetic heart valve to virtually implant a computer-aided-design (CAD) model of THV and evaluate the neo-LVOT area. A numerical simulation of THV deployment was then developed to assess the anchorage of the THV to the bioprosthetic heart valve as well as the resulting Von Mises stress at the mitral annulus and the contract pressure among implanted bioprostheses. Quantification of neo-LVOT and THV deployment may facilitate more accurate predictions of the LVOT obstruction in TMVR and help clinicians in the optimal choice of the THV size.

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Predicting Outcome of Aortic Dissection with Patent False Lumen by Computational Flow Analysis

Cited by 34 publications

References 31 publications

Statistical Shape Analysis of Ascending Thoracic Aortic Aneurysm: Correlation between Shape and Biomechanical Descriptors

Statistical Shape Analysis of Ascending Thoracic Aortic Aneurysm: Correlation between Shape and Biomechanical Descriptors

Role of Computational Modeling in Thoracic Aortic Pathology: A Review

Pre-Operative Modeling of Transcatheter Mitral Valve Replacement in a Surgical Heart Valve Bioprosthesis

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