A patient-specific study of type-B aortic dissection: evaluation of true-false lumen blood exchange

BioMedical Engineering OnLine

Duanduan Chen²  Matthias Müller-Eschner⁵  Hendrik von Tengg-Kobligk³  David Barber¹  Dittmar Böckler⁴  Rod Hose¹  Yiannis Ventikos⁶ 

[1] Department of Cardiovascular Science, Medical Physics Group, University of Sheffield, Sheffield, UK

[2] Department of Biomedical Engineering, School of Life Science, Beijing Institute of Technology, Beijing, China

[3] Institute for Diagnostic, Interventional and Pediatric Radiology (DIPR), Inselspital, University Hospital, Bern, Switzerland

[4] Department of Vascular Surgery, University of Heidelberg, Heidelberg, Germany

[5] Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany

[6] Department of Mechanical Engineering, University College London, London, UK

关键词: Hemodynamics;    Patient-specific model;    Computational fluid dynamics;    Aortic dissection;   

Others  :  797745
DOI  :  10.1186/1475-925X-12-65

 received in 2013-04-05, accepted in 2013-07-01,  发布年份 2013

【 摘 要 】

Background

Aortic dissection is a severe pathological condition in which blood penetrates between layers of the aortic wall and creates a duplicate channel – the false lumen. This considerable change on the aortic morphology alters hemodynamic features dramatically and, in the case of rupture, induces markedly high rates of morbidity and mortality.

Methods

In this study, we establish a patient-specific computational model and simulate the pulsatile blood flow within the dissected aorta. The k-ω SST turbulence model is employed to represent the flow and finite volume method is applied for numerical solutions. Our emphasis is on flow exchange between true and false lumen during the cardiac cycle and on quantifying the flow across specific passages. Loading distributions including pressure and wall shear stress have also been investigated and results of direct simulations are compared with solutions employing appropriate turbulence models.

Results

Our results indicate that (i) high velocities occur at the periphery of the entries; (ii) for the case studied, approximately 40% of the blood flow passes the false lumen during a heartbeat cycle; (iii) higher pressures are found at the outer wall of the dissection, which may induce further dilation of the pseudo-lumen; (iv) highest wall shear stresses occur around the entries, perhaps indicating the vulnerability of this region to further splitting; and (v) laminar simulations with adequately fine mesh resolutions, especially refined near the walls, can capture similar flow patterns to the (coarser mesh) turbulent results, although the absolute magnitudes computed are in general smaller.

Conclusions

The patient-specific model of aortic dissection provides detailed flow information of blood transport within the true and false lumen and quantifies the loading distributions over the aorta and dissection walls. This contributes to evaluating potential thrombotic behavior in the false lumen and is pivotal in guiding endovascular intervention. Moreover, as a computational study, mesh requirements to successfully evaluate the hemodynamic parameters have been proposed.

【 授权许可】

   
2013 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

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