Stokes, C; Haupt, F; Becker, D; Muthurangu, V; von Tengg-Kobligk, H; Balabani, S; Díaz-Zuccarini, V (2023). The Influence of Minor Aortic Branches in Patient-Specific Flow Simulations of Type-B Aortic Dissection. Annals of biomedical engineering, 51(7), pp. 1627-1644. Springer 10.1007/s10439-023-03175-4
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Type-B aortic dissection (TBAD) is a disease in which a tear develops in the intimal layer of the descending aorta forming a true lumen and false lumen (FL). Because disease outcomes are thought to be influenced by haemodynamic quantities such as pressure and wall shear stress (WSS), their analysis via numerical simulations may provide valuable clinical insights. Major aortic branches are routinely included in simulations but minor branches are virtually always neglected, despite being implicated in TBAD progression and the development of complications. As minor branches are estimated to carry about 7-21% of cardiac output, neglecting them may affect simulation accuracy. We present the first simulation of TBAD with all pairs of intercostal, subcostal and lumbar arteries, using 4D-flow MRI (4DMR) to inform patient-specific boundary conditions. Compared to an equivalent case without minor branches, their inclusion improved agreement with 4DMR velocities, reduced time-averaged WSS (TAWSS) and transmural pressure and elevated oscillatory shear in regions where FL dilatation and calcification were observed in vivo. Minor branch inclusion resulted in differences of 60-75% in these metrics of potential clinical relevance, indicating a need to account for minor branch flow loss if simulation accuracy is sought.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology |
UniBE Contributor: |
Haupt, Fabian, Becker, Daniel, von Tengg-Kobligk, Hendrik |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1573-9686 |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
27 Mar 2023 10:55 |
Last Modified: |
27 Feb 2024 14:27 |
Publisher DOI: |
10.1007/s10439-023-03175-4 |
PubMed ID: |
36967447 |
Uncontrolled Keywords: |
4D-flow MRI Aortic dissection Computational fluid dynamics Inferior mesenteric artery Intercostal arteries Lumbar arteries Patient-specific Segmental arteries |
BORIS DOI: |
10.48350/180694 |
URI: |
https://boris.unibe.ch/id/eprint/180694 |
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