Investigations into the Potential of Using Open Source CFD to Analyze the Differences in Hemodynamic Parameters for Aortic Dissections (Healthy versus Stanford Type A and B)

Ann Vasc Surg. 2022 Feb:79:310-323. doi: 10.1016/j.avsg.2021.08.007. Epub 2021 Oct 12.

Abstract

Background: The objective of this study was to develop a method to evaluate the effects of an aortic dissection on hemodynamic parameters by conducting a comparison with that of a healthy (nondissected) aorta. Open-source software will be implemented, no proprietary software/application will be used to ensure accessorily and repeatability, in all the data analysis and processing. Computed tomography (CT) images of aortic dissection are used for the model geometry segmentation. Boundary conditions from literature are implemented to computational fluid dynamics (CFD) to analyze the hemodynamic parameters.

Methods: A numerical simulation model was created by obtaining accurate 3-dimensional geometries of aortae from CT images. In this study, CT images of 8 cases of aortic dissection (Stanford type-A and type-B) and 3 cases of healthy aortae are used for the actual aorta model geometry segmentation. These models were exported into an open-source CFD software, OpenFOAM, where a simplified pulsating flow was simulated by controlling the flow pressure. Ten cycles of the pulsatile flow (0.50 sec/cycle) conditions, totaling 5 sec, were calculated.

Results: The pressure distribution, wall shear stress (WSS) and flow velocity streamlines within the aorta and the false lumen were calculated and visualized. It was found that the flow velocity and WSS had a high correlation in high WSS areas of the intermittent layer between the true and false lumen. Most of the Stanford type-A dissections in the study showed high WSS, over 38 Pa, at the systole phase. This indicates that the arterial walls in type-A dissections are more likely to be damaged with pulsatile flow.

Conclusions: Using CFD to estimate localized high WSS areas may help in deciding to treat a type-A or B dissection with a stent graft to prevent a potential rupture.

MeSH terms

  • Aorta / diagnostic imaging
  • Aorta / physiopathology*
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / physiopathology*
  • Aortic Aneurysm / therapy
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / physiopathology*
  • Aortic Dissection / therapy
  • Aortography
  • Case-Control Studies
  • Clinical Decision-Making
  • Computed Tomography Angiography
  • Hemodynamics*
  • Humans
  • Hydrodynamics
  • Models, Cardiovascular*
  • Numerical Analysis, Computer-Assisted
  • Patient-Specific Modeling*
  • Prognosis