دورية أكاديمية
أعرض في EDS

Patient-Specific Haemodynamic Analysis of Virtual Grafting Strategies in Type-B Aortic Dissection: Impact of Compliance Mismatch.

التفاصيل البيبلوغرافية
العنوان: Patient-Specific Haemodynamic Analysis of Virtual Grafting Strategies in Type-B Aortic Dissection: Impact of Compliance Mismatch.
المؤلفون: Girardin L; Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK., Stokes C; Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK., Thet MS; Department of Cardiothoracic Surgery, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK., Oo AY; Department of Cardiothoracic Surgery, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK., Balabani S; Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK., Díaz-Zuccarini V; Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK. v.diaz@ucl.ac.uk.; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, 43-45 Foley Street, London, W1W 7TS, UK. v.diaz@ucl.ac.uk.
المصدر: Cardiovascular engineering and technology [Cardiovasc Eng Technol] 2024 Jun; Vol. 15 (3), pp. 290-304. Date of Electronic Publication: 2024 Mar 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 101531846 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1869-4098 (Electronic) Linking ISSN: 1869408X NLM ISO Abbreviation: Cardiovasc Eng Technol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Springer
مواضيع طبية MeSH: Aortic Dissection*/surgery , Aortic Dissection*/physiopathology , Aortic Dissection*/diagnostic imaging , Blood Vessel Prosthesis Implantation*/instrumentation , Blood Vessel Prosthesis Implantation*/adverse effects , Models, Cardiovascular* , Patient-Specific Modeling* , Hemodynamics* , Blood Vessel Prosthesis* , Vascular Stiffness* , Computed Tomography Angiography*, Humans ; Prosthesis Design ; Treatment Outcome ; Magnetic Resonance Imaging, Cine ; Aortography ; Male ; Arterial Pressure ; Middle Aged ; Aortic Aneurysm/surgery ; Aortic Aneurysm/diagnostic imaging ; Aortic Aneurysm/physiopathology ; Stress, Mechanical ; Polyethylene Terephthalates ; Predictive Value of Tests
مستخلص: Introduction: Compliance mismatch between the aortic wall and Dacron Grafts is a clinical problem concerning aortic haemodynamics and morphological degeneration. The aortic stiffness introduced by grafts can lead to an increased left ventricular (LV) afterload. This study quantifies the impact of compliance mismatch by virtually testing different Type-B aortic dissection (TBAD) surgical grafting strategies in patient-specific, compliant computational fluid dynamics (CFD) simulations.
Materials and Methods: A post-operative case of TBAD was segmented from computed tomography angiography data. Three virtual surgeries were generated using different grafts; two additional cases with compliant grafts were assessed. Compliant CFD simulations were performed using a patient-specific inlet flow rate and three-element Windkessel outlet boundary conditions informed by 2D-Flow MRI data. The wall compliance was calibrated using Cine-MRI images. Pressure, wall shear stress (WSS) indices and energy loss (EL) were computed.
Results: Increased aortic stiffness and longer grafts increased aortic pressure and EL. Implementing a compliant graft matching the aortic compliance of the patient reduced the pulse pressure by 11% and EL by 4%. The endothelial cell activation potential (ECAP) differed the most within the aneurysm, where the maximum percentage difference between the reference case and the mid (MDA) and complete (CDA) descending aorta replacements increased by 16% and 20%, respectively.
Conclusion: This study suggests that by minimising graft length and matching its compliance to the native aorta whilst aligning with surgical requirements, the risk of LV hypertrophy may be reduced. This provides evidence that compliance-matching grafts may enhance patient outcomes.
(© 2024. The Author(s).)
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust; NS/A000050/1 Wellcome / EPSRC Centre for Interventional and Surgical Sciences; NH/20/1/34705 United Kingdom BHF_ British Heart Foundation
فهرسة مساهمة: Keywords: CFD simulation; Compliance mismatch; Dacron graft; Type-B aortic dissection; Virtual interventions
المشرفين على المادة: 0 (Polyethylene Terephthalates)
تواريخ الأحداث: Date Created: 20240304 Date Completed: 20240711 Latest Revision: 20240714
رمز التحديث: 20240714
مُعرف محوري في PubMed: PMC11239731
DOI: 10.1007/s13239-024-00713-6
PMID: 38438692
قاعدة البيانات: MEDLINE
الوصف
تدمد:1869-4098
DOI:10.1007/s13239-024-00713-6