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Updated: May 11, 2026
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Unsuccessful aortic fenestration for aortic dissection complicated with mesenteric malperfusion analyzed using
Shoki Iwanaga1, Naoyuki Kimura2, Shuta Imada3
1Department of Surgery, Division of Cardiovascular Surgery, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, 329-0498, Japan.
Background:
We report a computational fluid dynamics (CFD)-based analysis of an unsuccessful open fenestration for aortic dissection with mesenteric malperfusion.
Case Presentation:
A 75-year-old male was admitted for acute type B aortic dissection complicated by mesenteric malperfusion. He had a concomitant infrarenal abdominal aneurysm, prompting surgical infrarenal fenestration. Intraoperatively, the proximal intimal flap was resected near the renal arteries, and the aneurysm was replaced with a prosthetic graft. Despite the intervention, mesenteric malperfusion worsened, requiring additional endovascular aortic repair. CFD analysis revealed persistent false lumen flow and true lumen compression due to a large entry tear and residual proximal anastomotic stenosis.
Conclusion:
CFD analysis suggests that a large entry tear and residual stenosis from insufficient fenestration may result in inadequate false lumen depressurization.
