CFD Reconstruction of Blood Hemodynamic Based on a Self-made Algorithm in Patients with Acute Type IIIb Aortic Dissection Treated with TEVAR Procedure

Abstract

Background: Combination of computational fluid dynamic (CFD) technique and medical data (AngioCT and USG-Doppler data) allowed preparation of a non-invasive method for blood hemodynamic analysis in type B aortic dissection (TBAD). Materials and methods: Three-dimensional digital models of the aorta were reconstructed using pre- and post-operative data from a 39-year-old patient treated for acute TBAD with thoracic endovascular aortic repair (TEVAR). Moreover, the left renal artery and the right common iliac artery were treated with additional stents. CFD technique was used to quantify the displacement forces acting on the aortic wall in the areas of endograft and validated with USG-Doppler data. The aortic segment was extended from the origin of the aortic arch to the aortic bifurcation. Results: Our results indicated that prostheses implantation improved overall aortic blood flow. We observed that blood flow rate was around two-fold higher in branching arteries of the aorta after surgical procedure. The wall shear stress (WSS) values were lower in all analysed areas. Hence, the overall risk of dissection propagation and rupture was decreased. Conclusion: CFD technique may provide qualitative assessment of hemodynamic forces in the aorta before and after prostheses implantation and may have potential in aiding the therapeutic decision-making process after operation.