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Predicting Aneurysmal Degeneration in Uncomplicated Residual Type B Aortic Dissection
Arianna Forneris1,2, Ali Fatehi Hassanabad3, Jehangir J Appoo3
1Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada.
Bioengineering (Basel, Switzerland)
|July 27, 2024
Summary
Predicting aneurysm formation in type B aortic dissection (AD) is crucial. Patient-specific hemodynamics, like false lumen (FL) flow rate and tortuosity, can indicate risk and guide personalized management for AD patients.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Medical Imaging
Background:
- Aneurysm formation in the false lumen (FL) is a common complication for patients with type B aortic dissection (AD).
- Predicting which patients will develop aneurysms is vital for determining the need for interventional therapy.
- Personalized management strategies for AD can be improved by understanding patient-specific hemodynamics.
Purpose of the Study:
- To investigate patient-specific hemodynamics and geometric features in type B AD patients.
- To analyze correlations between hemodynamic descriptors and adverse outcomes such as rapid aortic growth or death.
- To identify potential indicators for predicting aneurysm formation and guiding disease management.
Main Methods:
- Retrospective analysis of individual aortas using computational fluid dynamics (CFD).
- Assessment of hemodynamic descriptors and geometric features in a cohort of residual type B AD patients.
- Correlation analysis between CFD-derived data and known patient outcomes.
Main Results:
- Significant variability in flow patterns and hemodynamic descriptors was observed among patients.
- Rapid aortic expansion was associated with a larger false lumen (FL).
- High FL flow rate, tortuosity, and time-averaged wall shear stress at the tear region were linked to adverse outcomes and disease progression.
Conclusions:
- Patient-specific hemodynamic assessment using CFD can complement anatomical evaluation in type B AD.
- Hemodynamic factors like FL flow rate and tortuosity may serve as indicators of risk for adverse outcomes.
- A tailored approach to disease management is essential for uncomplicated type B AD patients, leveraging CFD-derived insights.
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