Computational Fluid Dynamics Simulations to Predict False Lumen Enlargement After Surgical Repair of Type-A Aortic Dissection.
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 c...
| Published in: | Seminars in Thoracic & Cardiovascular Surgery Vol. 34; no. 2; pp. 443 - 449 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Published: |
W B Saunders
Summer2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157104152&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157104152 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10430679 3A04 jtl: Seminars in Thoracic & Cardiovascular Surgery issn: 10430679 maglogo: N pubinfo: dt: Summer2022 vid: 34 iid: 2 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 157104152 157104152 NLM34091015 10.1053/j.semtcvs.2021.05.012 NLM34091015 157104152 ppf: 443 ppct: 6 formats: tig: atl: Computational Fluid Dynamics Simulations to Predict False Lumen Enlargement After Surgical Repair of Type-A Aortic Dissection. aug: au: Shad, Rohan Kong, Sandra Fong, Robyn Quach, Nicolas Kasinpila, Patpilai Bowles, Cayley Lee, Anson Hiesinger, William affil: Department of Cardiothoracic Surgery, Stanford University School of Medicine, California sug: subj: Aneurysm, Dissecting Surgery Aortic Aneurysm Etiology Blood Vessel Prosthesis Adverse Effects Aortic Aneurysm Surgery Aortic Aneurysm Aortic Aneurysm, Thoracic Surgery Aneurysm, Dissecting Physiochemical Phenomena Treatment Outcomes Models, Biological Retrospective Design ab: 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. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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