Study of Haemodynamic Effects of Entry- and Exit-Tear Coverage in a DeBakey Type III Aortic Dissection: Technical Report

Thoracic Aorta


Computational Study of Haemodynamic Effects of Entry- and Exit-Tear Coverage in a DeBakey Type III Aortic Dissection: Technical Report


Karmonik C, Bismuth J, Shah DJ, et al (The Methodist Hosp, Houston, TX; et al) Eur J Vasc Endovasc Surg 42:172–177, 2011§



B.W. Starnes, MD



Evidence Ranking


• D



Expert Rating


• 2



Abstract



Objectives


Outcome prediction in DeBakey Type III aortic dissections (ADs) remains challenging. Large variations in AD morphology, physiology and treatment exist. Here, we investigate if computational fluid dynamics (CFD) can provide an initial understanding of pressure changes in an AD computational model when covering entry and exit tears and removing the intra-arterial septum (IS).



Design


A computational mesh was constructed from magnetic resonance images from one patient (one entrance and one exit tear) and CFD simulations performed (scenario #1). Additional meshes were derived by virtually (1) covering the exit tear (false lumen (FL) thrombus progression) (scenario #2), (2) covering the entrance tear (thoracic endovascular treatment, TEVAR) (scenario #3) and (3) completely removing the IS (fenestration) (scenario #4). Changes in flow patterns and pressures were quantified relative to the initial mesh.



Results


Systolic pressures increased for #2 (300 Pa increase) with largest inter-luminal differences distally (2500 Pa). In #3, false lumen pressure decreased essentially to zero. In #4, systolic pressure in combined lumen reduced from 2400 to 800 Pa.

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Apr 1, 2017 | Posted by in CARDIOLOGY | Comments Off on Study of Haemodynamic Effects of Entry- and Exit-Tear Coverage in a DeBakey Type III Aortic Dissection: Technical Report

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