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Fluid- and Biomechanical Analysis of Ascending Thoracic Aorta Aneurysm with Concomitant Aortic Insufficiency

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Abstract

We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemodynamics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair. The healthy volunteers showed no eccentric blood flow, a mean TAWSS of 1.5 ± 0.3 Pa and mean OSI of 0.325 ± 0.025. In 3 aneurismal patients, jet flow impingement on the aortic wall resulted in large TAWSS values and low OSI which were amplified by the AI degree. However, the tissue strength did not appear to be significantly reduced. The fourth patient, which showed the lowest TAWSS due to the absence of jet flow, had the smallest strength in vitro. Interestingly this patient presented a bovine arch abnormality. Jet flow impingement with high WSS values is frequent in ATAAs and our methodology seems to be appropriate for determining whether it may increase the risk of rupture or not.

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Acknowledgments

This research was supported by the European Research Council (ERC Grant biolochanics, Grant Number 647067). We thank Dr Morbiducci and Dr Gallo from Polytechnic of Turin (Italy) who provided insight and expertise that greatly assisted this research. We are also grateful to Ansys, Inc. for providing Ansys-Fluent (ANSYS® Academic Research, Release 17.0).

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Authors and Affiliations

  1. Ecole Nationale Supérieure des Mines de Saint-Etienne, CIS-EMSE, SAINBIOSE, 42023, Saint-Etienne, France

    F. Condemi, O. Trabelsi, C. Cavinato & S. Avril

  2. INSERM U1059, SAINBIOSE, 42023, Saint-Etienne, France

    F. Condemi, O. Trabelsi, C. Cavinato & S. Avril

  3. Université de Lyon, Lyon, F-69000, France

    F. Condemi, O. Trabelsi, C. Cavinato & S. Avril

  4. CHU Hôpital Nord, Saint-Etienne, France

    S. Campisi, M. Viallon, P. Croisille & A. Duprey

  5. Univ Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, 42023, Saint-Etienne, France

    M. Viallon & P. Croisille

  6. Siemens Healthcare, Saint-Denis, France

    T. Troalen

  7. Circle Cardiovascular Imaging Inc., Panarctic Plaza, Calgary, Canada

    G. Xuexin

  8. Northwestern University, Chicago, IL, USA

    A. J. Barker & M. Markl

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  1. F. Condemi
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  2. S. Campisi
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  10. C. Cavinato
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Corresponding author

Correspondence to F. Condemi.

Additional information

Associate Editor Estefanía Peña oversaw the review of this article.

Appendix

Appendix

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Figure 6
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Pressure plots for the different case studies.

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Condemi, F., Campisi, S., Viallon, M. et al. Fluid- and Biomechanical Analysis of Ascending Thoracic Aorta Aneurysm with Concomitant Aortic Insufficiency. Ann Biomed Eng 45, 2921–2932 (2017). https://doi.org/10.1007/s10439-017-1913-6

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