Although Type B aortic dissection (AoD) has better in-hospital survival than Type A AoD, the short- and long term outcome for patients remains challenging, with 50–80% deaths at 5-years. Dissection-related complications include rapid aortic expansion, impending rupture, and malperfusion syndromes. We aimed to assess hemodynamic implications of patients with patent false lumen (FL) of dissected aorta. Computational fluid dynamic analyses were performed on patient-specific aortic geometries reconstructed from computed tomography scans of 25 patients with AoDs, who were admitted in our hospital from 2007 to 2013. We used the development of acute complications and chronic aneurysmal evolution as patient endpoints. Anatomical variables were correlated with hemodynamic variables, and regression was then performed to show independent determinants of FL flow. Velocity streamlines revealed helical, slower-moving flow in the FL of AoDs. Blood pressure and wall shear stress varied markedly between subjects, depending on AoD geometry. Lastly, linear regression shown that the height of entry tears was a significant predictor of blood flow through the patent FL. The greater the entry tear is, the greater the flow in the patent FL and thus the risk of dissection-related complications. Computational flow analysis may lead to more confident predictions of which patients will suffer adverse events and facilitate the clinical decision-making process related to the treatment of Type B AoDs.

Rinaudo, A., D'Ancona, G., Lee, J.J., Pilato, G., Amaducci, A., Baglini, R., et al. (2014). Predicting Outcome of Aortic Dissection with Patent False Lumen by Computational Flow Analysis. CARDIOVASCULAR ENGINEERING AND TECHNOLOGY, 5(2), 176-188 [10.1007/s13239-014-0182-x].

Predicting Outcome of Aortic Dissection with Patent False Lumen by Computational Flow Analysis

RINAUDO, Antonino;Pasta, S.
2014-01-01

Abstract

Although Type B aortic dissection (AoD) has better in-hospital survival than Type A AoD, the short- and long term outcome for patients remains challenging, with 50–80% deaths at 5-years. Dissection-related complications include rapid aortic expansion, impending rupture, and malperfusion syndromes. We aimed to assess hemodynamic implications of patients with patent false lumen (FL) of dissected aorta. Computational fluid dynamic analyses were performed on patient-specific aortic geometries reconstructed from computed tomography scans of 25 patients with AoDs, who were admitted in our hospital from 2007 to 2013. We used the development of acute complications and chronic aneurysmal evolution as patient endpoints. Anatomical variables were correlated with hemodynamic variables, and regression was then performed to show independent determinants of FL flow. Velocity streamlines revealed helical, slower-moving flow in the FL of AoDs. Blood pressure and wall shear stress varied markedly between subjects, depending on AoD geometry. Lastly, linear regression shown that the height of entry tears was a significant predictor of blood flow through the patent FL. The greater the entry tear is, the greater the flow in the patent FL and thus the risk of dissection-related complications. Computational flow analysis may lead to more confident predictions of which patients will suffer adverse events and facilitate the clinical decision-making process related to the treatment of Type B AoDs.
2014
Settore ING-IND/14 - Progettazione Meccanica E Costruzione Di Macchine
Rinaudo, A., D'Ancona, G., Lee, J.J., Pilato, G., Amaducci, A., Baglini, R., et al. (2014). Predicting Outcome of Aortic Dissection with Patent False Lumen by Computational Flow Analysis. CARDIOVASCULAR ENGINEERING AND TECHNOLOGY, 5(2), 176-188 [10.1007/s13239-014-0182-x].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/99032
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