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Numerical analysis of wall shear stress in ascending aorta before tearing in type A aortic dissection

Qingzhuo Chi1, Ying He1, Yong Luan2

  • 1Key Laboratory of Ocean Energy Utilization and Energy Conservation of Ministry of Education, Dalian University of Technology, Dalian, 116024, China.

Computers in Biology and Medicine
|August 27, 2017
PubMed

Insights

Elevated wall shear stress (WSS) in the aorta correlates with tearing in type A aortic dissection (AD). Morphological changes like ascending aorta dilation and altered aortic arch branching angles contribute to high WSS, increasing AD risk.

Area of Science:

  • Cardiovascular Science
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Aortic dissection (AD) prevalence is increasing despite advances in cardiovascular disease treatment.
  • Type A aortic dissection is more severe than type B, often necessitating surgical intervention.

Purpose of the Study:

  • To investigate the relationship between wall shear stress (WSS) on the aortic endothelium and common tearing locations in type A aortic dissection.
  • To utilize computational fluid dynamics (CFD) to analyze hemodynamic factors in AD.

Main Methods:

  • Reconstruction of pre-dissection aortic structures from imaging data for five type A AD cases and two normal aortas.
  • Computational fluid dynamics analysis of blood flow and WSS in reconstructed aortic models.
  • Comparison of WSS and hemodynamic parameters between AD cases and control subjects.

Main Results:

  • Rupture sites in three of five AD cases coincided with areas of maximum elevated WSS.
  • Elevated WSS was observed at the aortic arch-descending aorta junction, linked to disturbed helical flow.
  • WSS in pre-dissection AD patients was nearly double that of the control group.
  • Ascending aorta dilation and altered aortic arch branching angles were identified as key determinants of high WSS leading to type A AD.
  • Increased aortic arch tortuosity was associated with stronger helical flow, potentially causing tears.

Conclusions:

  • High wall shear stress, influenced by aortic morphology such as ascending aorta dilation and altered branching angles, is a significant factor in type A aortic dissection.
  • Computational fluid dynamics provides valuable insights into the biomechanical factors contributing to AD.
  • Understanding these hemodynamic and morphological relationships can aid in predicting and potentially preventing aortic dissection.

Keywords:
Aortic dissectionComputational fluid dynamicsImage-based modelingPatient-specific modelStructured mesh generationWall shear stress

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