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Erschienen in: CardioVascular and Interventional Radiology 8/2016

11.05.2016 | Clinical Investigation

The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection

verfasst von: Simon C. H. Yu, Wen Liu, Randolph H. L. Wong, Malcolm Underwood, Defeng Wang

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 8/2016

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Abstract

Purpose

We aimed to assess the potential of computational fluid dynamics simulation (CFD) in detecting changes in pressure and flow velocity in response to morphological changes in type B aortic dissection.

Materials and Methods

Pressure and velocity in four morphological models of type B aortic dissection before and after closure of the entry tear were calculated with CFD and analyzed for changes among the different scenarios. The control model (Model 1) was patient specific and built from the DICOM data of CTA, which bore one entry tear and three re-entry tears. Models 2–4 were modifications of Model 1, with two re-entry tears less in Model 2, one re-entry tear more in Model 3, and a larger entry tear in Model 4.

Results

The pressure and velocity pertaining to each of the morphological models were unique. Changes in pressure and velocity findings were accountable by the changes in morphological features of the different models. There was no blood flow in the false lumen across the entry tear after its closure, the blood flow direction across the re-entry tears was reversed after closure of the entry tear.

Conclusion

CFD simulation is probably useful to detect hemodynamic changes in the true and false lumens of type B aortic dissection in response to morphological changes, it may potentially be developed into a non-invasive and patient-specific tool for serial monitoring of hemodynamic changes of type B aortic dissection before and after treatment.
Literatur
1.
Zurück zum Zitat Nienaber CA, Fattori R, Lund G, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent–graft placement. N Engl J Med. 1999;340:1539–45.CrossRefPubMed Nienaber CA, Fattori R, Lund G, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent–graft placement. N Engl J Med. 1999;340:1539–45.CrossRefPubMed
2.
Zurück zum Zitat Dake MD, Kato N, Mitchell RS, et al. Endovascular stent–graft placement for the treatment of acute aortic dissection. N Engl J Med. 1999;340:1546–52.CrossRefPubMed Dake MD, Kato N, Mitchell RS, et al. Endovascular stent–graft placement for the treatment of acute aortic dissection. N Engl J Med. 1999;340:1546–52.CrossRefPubMed
3.
Zurück zum Zitat Hanna JM, Andersen ND, Ganapathi AM, McCann RL, Hughes GC. Five-year results for endovascular repair of acute complicated type B aortic dissection. J Vasc Surg. 2014;59:96–106.CrossRefPubMed Hanna JM, Andersen ND, Ganapathi AM, McCann RL, Hughes GC. Five-year results for endovascular repair of acute complicated type B aortic dissection. J Vasc Surg. 2014;59:96–106.CrossRefPubMed
4.
Zurück zum Zitat Böckler D, Schumacher H, Ganten M, et al. Complications after endovascular repair of acute symptomatic and chronic expanding Stanford type B aortic dissections. J Thorac Cardiovasc Surg. 2006;132:361–8.CrossRefPubMed Böckler D, Schumacher H, Ganten M, et al. Complications after endovascular repair of acute symptomatic and chronic expanding Stanford type B aortic dissections. J Thorac Cardiovasc Surg. 2006;132:361–8.CrossRefPubMed
5.
Zurück zum Zitat Ehrlich MP, Dumfarth J, Schoder M, et al. Midterm results after endovascular treatment of acute, complicated type B aortic dissection. Ann Thorac Surg. 2010;90:1444–9.CrossRefPubMed Ehrlich MP, Dumfarth J, Schoder M, et al. Midterm results after endovascular treatment of acute, complicated type B aortic dissection. Ann Thorac Surg. 2010;90:1444–9.CrossRefPubMed
6.
Zurück zum Zitat Chung JW, Elkins C, Sakai T, et al. True-lumen collapse in aortic dissection: part I. Evaluation of causative factors in phantoms with pulsatile flow. Radiology. 2000;214:87–98.CrossRefPubMed Chung JW, Elkins C, Sakai T, et al. True-lumen collapse in aortic dissection: part I. Evaluation of causative factors in phantoms with pulsatile flow. Radiology. 2000;214:87–98.CrossRefPubMed
7.
Zurück zum Zitat Chung JW, Elkins C, Sakai T, et al. True-lumen collapse in aortic dissection: part II. Evaluation of treatment methods in phantoms with pulsatile flow. Radiology. 2000;214:99–106.CrossRefPubMed Chung JW, Elkins C, Sakai T, et al. True-lumen collapse in aortic dissection: part II. Evaluation of treatment methods in phantoms with pulsatile flow. Radiology. 2000;214:99–106.CrossRefPubMed
8.
Zurück zum Zitat Marui A, Mochizuki T, Mitsui N, et al. Toward the best treatment for uncomplicated patients with type B acute aortic dissection: a consideration for sound surgical indication. Circulation. 1999;100(Suppl II):II-275–80. Marui A, Mochizuki T, Mitsui N, et al. Toward the best treatment for uncomplicated patients with type B acute aortic dissection: a consideration for sound surgical indication. Circulation. 1999;100(Suppl II):II-275–80.
9.
Zurück zum Zitat Sueyoshi E, Sakamoto I, Hayashi K, Yamaguchi T, Imada T. Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase. Circulation. 2004;110(Suppl II):II-256–61. Sueyoshi E, Sakamoto I, Hayashi K, Yamaguchi T, Imada T. Growth rate of aortic diameter in patients with type B aortic dissection during the chronic phase. Circulation. 2004;110(Suppl II):II-256–61.
10.
Zurück zum Zitat Chen D, Müller-Eschner M, von Tengg-Kobligk H, Barber D, Böckler D, Hose R. A patient-specific study of type-B aortic dissection: evaluation of true-false lumen blood exchange. Biomed Eng. 2013;12:65. Chen D, Müller-Eschner M, von Tengg-Kobligk H, Barber D, Böckler D, Hose R. A patient-specific study of type-B aortic dissection: evaluation of true-false lumen blood exchange. Biomed Eng. 2013;12:65.
11.
Zurück zum Zitat Karmonik C, Müller-Eschner M, Partovi S, Geisbüsch P, Ganten MK, Bismuth J. Computational fluid dynamics investigation of chronic aortic dissection hemodynamics versus normal aorta. Vas Endovasc Surg. 2013;47(8):625–31.CrossRef Karmonik C, Müller-Eschner M, Partovi S, Geisbüsch P, Ganten MK, Bismuth J. Computational fluid dynamics investigation of chronic aortic dissection hemodynamics versus normal aorta. Vas Endovasc Surg. 2013;47(8):625–31.CrossRef
12.
Zurück zum Zitat Fung YC. Biomechanics: circulation. 2nd ed. New York: Springer; 1997. p. 108–200.CrossRef Fung YC. Biomechanics: circulation. 2nd ed. New York: Springer; 1997. p. 108–200.CrossRef
13.
Zurück zum Zitat Mills CJ, Gabe IT, Gault JH, et al. Pressure-flow relationships and vascular impedance in man. Cardiovasc Res. 1970;4(4):405–17.CrossRefPubMed Mills CJ, Gabe IT, Gault JH, et al. Pressure-flow relationships and vascular impedance in man. Cardiovasc Res. 1970;4(4):405–17.CrossRefPubMed
14.
Zurück zum Zitat Winnerkvist A, Lockowandt U, Rasmussen E, et al. A prospective study of medically treated acute type B aortic 51. dissection. Eur J Vasc Endovasc Surg. 2006;32:349–55.CrossRefPubMed Winnerkvist A, Lockowandt U, Rasmussen E, et al. A prospective study of medically treated acute type B aortic 51. dissection. Eur J Vasc Endovasc Surg. 2006;32:349–55.CrossRefPubMed
15.
Zurück zum Zitat Marui A, Mochizuki T, Koyama T, et al. Degree of fusiform dilatation of the proximal descending aorta in type B acute aortic dissection can predict late aortic events. J Thorac Cardiovasc Surg. 2007;134:1163–70.CrossRefPubMed Marui A, Mochizuki T, Koyama T, et al. Degree of fusiform dilatation of the proximal descending aorta in type B acute aortic dissection can predict late aortic events. J Thorac Cardiovasc Surg. 2007;134:1163–70.CrossRefPubMed
16.
Zurück zum Zitat Song JM, Kim SD, Kim JH, et al. Long-term predictors of descending aorta aneurysmal change in patients with aortic dissection. J Am Coll Cardiol. 2007;50:799–804.CrossRefPubMed Song JM, Kim SD, Kim JH, et al. Long-term predictors of descending aorta aneurysmal change in patients with aortic dissection. J Am Coll Cardiol. 2007;50:799–804.CrossRefPubMed
17.
Zurück zum Zitat Moulakakis KG, Mylonas SN, Dalainas I, Kakisis J, Kotsis T, Liapis CD. Management of complicated and uncomplicated acute type B dissection. A systematic review and meta-analysis. Ann Cardiothorac Surg. 2014;3(3):234–46.PubMedPubMedCentral Moulakakis KG, Mylonas SN, Dalainas I, Kakisis J, Kotsis T, Liapis CD. Management of complicated and uncomplicated acute type B dissection. A systematic review and meta-analysis. Ann Cardiothorac Surg. 2014;3(3):234–46.PubMedPubMedCentral
18.
Zurück zum Zitat Tsai TT, Schlicht MS, Khanafer K, et al. Tear size and location impacts false lumen pressure in an ex vivo model of chronic type B aortic dissection. J Vasc Surg. 2008;47:844–51.CrossRefPubMed Tsai TT, Schlicht MS, Khanafer K, et al. Tear size and location impacts false lumen pressure in an ex vivo model of chronic type B aortic dissection. J Vasc Surg. 2008;47:844–51.CrossRefPubMed
19.
Zurück zum Zitat Clough RE, Waltham M, Giese D, et al. A new imaging method for assessment of aortic dissection using four-dimensional phase contrast magnetic resonance imaging. J Vasc Surg. 2012;55:914–23.CrossRefPubMed Clough RE, Waltham M, Giese D, et al. A new imaging method for assessment of aortic dissection using four-dimensional phase contrast magnetic resonance imaging. J Vasc Surg. 2012;55:914–23.CrossRefPubMed
20.
Zurück zum Zitat Kinner S, Eggebrecht H, Maderwald S, et al. Dynamic MR angiography in acute aortic dissection. J Magn Reson Imaging. 2015;42:505–14.CrossRefPubMed Kinner S, Eggebrecht H, Maderwald S, et al. Dynamic MR angiography in acute aortic dissection. J Magn Reson Imaging. 2015;42:505–14.CrossRefPubMed
21.
Zurück zum Zitat Clough RE, Zymvragoudakis VE, Biasi L, Taylor PR. Usefulness of new imaging methods for assessment of type B aortic dissection. Ann Cardiothorac Surg. 2014;3(3):314–8.PubMedPubMedCentral Clough RE, Zymvragoudakis VE, Biasi L, Taylor PR. Usefulness of new imaging methods for assessment of type B aortic dissection. Ann Cardiothorac Surg. 2014;3(3):314–8.PubMedPubMedCentral
22.
Zurück zum Zitat Penco M, Paparoni S, Dagianti A. Usefulness of transesophageal echocardiography in the assessment of aortic dissection. Am J Cardiol. 2000;86:53–6.CrossRef Penco M, Paparoni S, Dagianti A. Usefulness of transesophageal echocardiography in the assessment of aortic dissection. Am J Cardiol. 2000;86:53–6.CrossRef
23.
Zurück zum Zitat Thorsgard ME, Morrissette GJ, Sun B, et al. Impact of intraoperative transesophageal echocardiography on acute type-A aortic dissection. J Cardiothorac Vasc Anesth. 2014;28:1203–7.CrossRefPubMed Thorsgard ME, Morrissette GJ, Sun B, et al. Impact of intraoperative transesophageal echocardiography on acute type-A aortic dissection. J Cardiothorac Vasc Anesth. 2014;28:1203–7.CrossRefPubMed
24.
Zurück zum Zitat Cheng Z, Juli C, Wood NB, Gibbs RGJ, Xu XY. Predicting flow in aortic dissection: comparison of computational model with PC-MRI velocity measurements. Med Eng Phys. 2014;36:1176–84.CrossRefPubMed Cheng Z, Juli C, Wood NB, Gibbs RGJ, Xu XY. Predicting flow in aortic dissection: comparison of computational model with PC-MRI velocity measurements. Med Eng Phys. 2014;36:1176–84.CrossRefPubMed
Metadaten
Titel
The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection
verfasst von
Simon C. H. Yu
Wen Liu
Randolph H. L. Wong
Malcolm Underwood
Defeng Wang
Publikationsdatum
11.05.2016
Verlag
Springer US
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 8/2016
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-016-1352-z

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