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Coupled Morphological–Hemodynamic Computational Analysis of Type B Aortic Dissection: A Longitudinal Study

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Abstract

Progressive false lumen aneurysmal degeneration in type B aortic dissection (TBAD) is a complex process with a multi-factorial etiology. Patient-specific computational fluid dynamics (CFD) simulations provide spatial and temporal hemodynamic quantities that facilitate understanding this disease progression. A longitudinal study was performed for a TBAD patient, who was diagnosed with the uncomplicated TBAD in 2006 and treated with optimal medical therapy but received surgery in 2010 due to late complication. Geometries of the aorta in 2006 and 2010 were reconstructed. With registration algorithms, we accurately quantified the evolution of the false lumen, while with CFD simulations we computed several hemodynamic indexes, including the wall shear stress (WSS), and the relative residence time (RRT). The numerical fluid model included large eddy simulation (LES) modeling for efficiently capturing the flow disturbances induced by the entry tears. In the absence of complete patient-specific data, the boundary conditions were based on a specific calibration method. Correlations between hemodynamics and the evolution field in time obtained by registration of the false lumen are discussed. Further testing of this methodology on a large cohort of patients may enable the use of CFD to predict whether patients, with originally uncomplicated TBAD, develop late complications.

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Abbreviations

CFD:

Computational fluid dynamics

AD:

Aortic dissection

TBAD:

Type B AD

uTBAD:

Uncomplicated TBAD

FL:

False lumen

TL:

True lumen

OMT:

Optimal medical therapy

WSS:

Wall shear stress

TAWSS:

Time averaged WSS

RRT:

Relative residence time

OSI:

Oscillatory shear index

3WK:

3 Element windkessel model

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Acknowledgments

US-NSF Project DMS 162040 and NSF-XSEDE TG-ASC160069. The authors thank Professor R. Nerem for many fruitful discussions.

Author information

Authors and Affiliations

  1. The George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, USA

    Huijuan Xu

  2. Department of Mathematics and Computer Science, Emory University, Atlanta, USA

    Huijuan Xu, Adrien Lefieux & Alessandro Veneziani

  3. Department of Radiology and Imaging Sciences, Emory University, Atlanta, USA

    Marina Piccinelli

  4. Department of Surgery, Emory University, Atlanta, USA

    Bradley G. Leshnower

  5. Department of Cardiology, Emory University, Atlanta, USA

    Adrien Lefieux & W. Robert Taylor

  6. Atlanta VA Medical Center, Atlanta, USA

    W. Robert Taylor

  7. School of Advanced Studies IUSS, Pavia, Italy

    Alessandro Veneziani

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  1. Huijuan Xu
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  2. Marina Piccinelli
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Correspondence to Huijuan Xu.

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Associate Editor Umberto Morbiducci oversaw the review of this article.

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Xu, H., Piccinelli, M., Leshnower, B.G. et al. Coupled Morphological–Hemodynamic Computational Analysis of Type B Aortic Dissection: A Longitudinal Study. Ann Biomed Eng 46, 927–939 (2018). https://doi.org/10.1007/s10439-018-2012-z

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  • DOI: https://doi.org/10.1007/s10439-018-2012-z

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