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Appl. Sci. 2018, 8(8), 1309; https://doi.org/10.3390/app8081309

Computational Fluid Dynamic Accuracy in Mimicking Changes in Blood Hemodynamics in Patients with Acute Type IIIb Aortic Dissection Treated with TEVAR

1
Faculty of Process and Environmental Engineering, Lodz University of Technology, Wolczanska 213, 90-924 Lodz, Poland
2
Department of Surgery, Division of Vascular Surgery, Medical University of Vienna, Spitalgasse 23, 1090 Wien, Austria
3
Department of Medical Biotechnology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Krakow, Poland
*
Author to whom correspondence should be addressed.
Received: 27 June 2018 / Revised: 28 July 2018 / Accepted: 1 August 2018 / Published: 7 August 2018
(This article belongs to the Section Applied Biosciences and Bioengineering)
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Abstract

Background: We aimed to verify the accuracy of the Computational Fluid Dynamics (CFD) algorithm for blood flow reconstruction for type IIIb aortic dissection (TBAD) before and after thoracic endovascular aortic repair (TEVAR). Methods: We made 3D models of the aorta and its branches using pre- and post-operative CT data from five patients treated for TBAD. The CFD technique was used to quantify the displacement forces acting on the aortic wall in the areas of endograft, mass flow rate/velocity and wall shear stress (WSS). Calculated results were verified with ultrasonography (USG-Doppler) data. Results: CFD results indicated that the TEVAR procedure caused a 7-fold improvement in overall blood flow through the aorta (p = 0.0001), which is in line with USG-Doppler data. A comparison of CFD results and USG-Doppler data indicated no significant change in blood flow through the analysed arteries. CFD also showed a significant increase in flow rate for thoracic trunk and renal arteries, which was in accordance with USG-Doppler data (accuracy 90% and 99.9%). Moreover, we observed a significant decrease in WSS values within the whole aorta after TEVAR compared to pre-TEVAR (1.34 ± 0.20 Pa vs. 3.80 ± 0.59 Pa, respectively, p = 0.0001). This decrease was shown by a significant reduction in WSS and WSS contours in the thoracic aorta (from 3.10 ± 0.27 Pa to 1.34 ± 0.11Pa, p = 0.043) and renal arteries (from 4.40 ± 0.25 Pa to 1.50 ± 0.22 Pa p = 0.043). Conclusions: Post-operative remodelling of the aorta after TEVAR for TBAD improved hemodynamic patterns reflected by flow, velocity and WSS with an accuracy of 99%. View Full-Text
Keywords: CFD simulation; aortic dissection; TEVAR; wall shear stress; blood flow CFD simulation; aortic dissection; TEVAR; wall shear stress; blood flow
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Polanczyk, A.; Piechota-Polanczyk, A.; Domenig, C.; Nanobachvili, J.; Huk, I.; Neumayer, C. Computational Fluid Dynamic Accuracy in Mimicking Changes in Blood Hemodynamics in Patients with Acute Type IIIb Aortic Dissection Treated with TEVAR. Appl. Sci. 2018, 8, 1309.

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