Abstract

Cardiovascular computational fluid dynamics (CFD) based on patient-specific modeling is increasingly used to predict changes in hemodynamic parameters before or after surgery/interventional treatment for aortic dissection (AD). This study investigated the effects of flow boundary conditions (BCs) on patient-specific aortic hemodynamics. We compared the changes in hemodynamic parameters in a type A dissection model and normal aortic model under different BCs: inflow from the auxiliary and truncated structures at aortic valve, pressure control and Windkessel model outflow conditions, and steady and unsteady inflow conditions. The auxiliary entrance remarkably enhanced the physiological authenticity of numerical simulations of flow in the ascending aortic cavity. Thus, the auxiliary entrance can well reproduce the injection flow from the aortic valve. In addition, simulations of the aortic model reconstructed with an auxiliary inflow structure and pressure control and the Windkessel model outflow conditions exhibited highly similar flow patterns and wall shear stress distribution in the ascending aorta under steady and unsteady inflow conditions. Therefore, the inflow structure at the valve plays a crucial role in the hemodynamics of the aorta. Under limited time and calculation cost, the steady-state study with an auxiliary inflow valve can reasonably reflect the blood flow state in the ascending aorta and aortic arch. With reasonable BC settings, cardiovascular CFD based on patient-specific AD models can aid physicians in noninvasive and rapid diagnosis.

Highlights

  • Aortic dissection (AD), caused by intimal splitting induced by pulsating blood, is one of the most complex cardiovascular diseases

  • The wall shear stress (WSS) was normalized to highlight the effect of the auxiliary entrance on the WSS distribution, which is defined as the ratio of the local WSS to the maximum WSS of the aortic model

  • We compared the changes in hemodynamic parameters in a type A dissection model and normal aortic model under different boundary conditions (BCs): inflow from the aortic valve, pressure control and 3-EWK outflow conditions, and steady and unsteady inflow conditions

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Summary

Introduction

Aortic dissection (AD), caused by intimal splitting induced by pulsating blood, is one of the most complex cardiovascular diseases. CMES, 2022, vol.131, no.1 blood passes through the tear into the aortic wall, and the aortic intima peels off [2]. Research has reported that high WSS (10 to 30 Pa) can cause endothelial cells to express a unique transcriptional profile that may be useful in expansive arterial remodeling [7]. The expansive remodeling and degeneration of elastic fibers in the aorta may be related to AD occurrence.

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