Blood flow patterns and pressure loss in the ascending aorta: A comparative study on physiological and aneurysmal conditions

Gülan, Utku; Calen, Christelle; Duru, Fırat; Holzner, Markus

doi:10.1016/j.jbiomech.2018.05.033

Cited by 22 publications

(19 citation statements)

References 27 publications

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“…The valves were placed in an anatomically accurate silicone replica of a healthy human aorta. As shown in Figure , a time‐of‐flight magnetic resonance angiogram (TOF‐MRA) was used to produce an anatomically correct physical replica of an aorta of a healthy proband . An optically transparent flexible silicone phantom (Elastrat Sarl, Geneva, Switzerland) was produced using the reconstructed 3D geometry of the aorta in stereolithography (STL) file format.…”

Section: Methodsmentioning

confidence: 99%

Performance analysis of the transcatheter aortic valve implantation on blood flow hemodynamics: An optical imaging‐based in vitro study

Gülan¹,

Appa

Corso³

et al. 2019

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Cardiac implants may have a strong influence on the hemodynamics of the circulatory system. In this study, we aimed at investigating the impact of transcatheter aortic valve implantation (TAVI) devices on blood flow patterns that develop in the ascending aorta under physiological flow conditions in vitro. For this purpose, a noninvasive optical measurement tool, three-dimensional particle tracking velocimetry (3D-PTV), was used in a realistic compliant silicone aortic model. The performance and the influence of two TAVIs and one surgical valve on the aortic flow were investigated. Our results showed that valve design and materials may have a distinct influence on relevant hemodynamic properties, namely kinetic energy, production of turbulence, and shear stresses in the ascending aorta. All properties varied considerably between the different valve models. We found that the total aortic regurgitation composed of the closing volume, transvalvular and paravalvular leakages varied for the three valves investigated. Furthermore, peak mean kinetic energy (MKE) ranged from 61 to 116 J/m 3 , whereas peak turbulent kinetic energy (TKE) ranged from 23 to 36 J/m 3 . The analysis of shear showed that all the three studied devices had minimal overall risk for thrombus formation. We conclude that the characteristics and material designs of TAVI devices have strong influences on the hemodynamics in the ascending aorta.

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Section: Methodsmentioning

confidence: 99%

Performance analysis of the transcatheter aortic valve implantation on blood flow hemodynamics: An optical imaging‐based in vitro study

Gülan¹,

Appa

Corso³

et al. 2019

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“…28 Gülan et al proposed elevated turbulence intensity and irreversible pressure loss as complementary indicators for assessing aneurysm severity in the ascending aorta. 29 Studies utilizing 4D flow MRI have also focused on WSS and OSI estimation. WSS is defined as the product of fluid viscosity and shearing velocity of the adjacent vascular wall.…”

Section: Pathological Hemodynamics Related To Aneurysm Formationmentioning

confidence: 99%

Utility of 4D Flow MRI in Thoracic Aortic Diseases: A Literature Review of Clinical Applications and Current Evidence

et al. 2022

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Despite the recent technical developments, surgery on the thoracic aorta remains challenging and is associated with significant mortality and morbidity. Decisions about when and if to operate are based on a balance between surgical risk and the hazard of aortic rupture. These decisions are sometimes difficult in elective cases of thoracic aortic diseases, including aneurysms and dissections. Abnormal wall stress derived from flow alterations influences disease progression. Therefore, a better understanding of the complex hemodynamic environment inside the aortic lumen will facilitate patient-specific risk assessments of complications, which enable clinicians to provide timely prophylactic interventions. Time-resolved 3D phase-contrast (4D flow) MRI has many advantages for the in vivo assessment of flow dynamics. Recent developments in 4D flow imaging techniques has led to significant advances in our understanding of physiological flow dynamics in healthy subjects and patients with thoracic aortic diseases. In this clinically focused review of thoracic aortic diseases, we demonstrate the clinical advances acquired with 4D flow MRI from published studies. We provide a systematic overview of key evidences and considerations regarding normal thoracic aortas, thoracic aortic aneurysms, aortic dissections, and thoracic aortas with prosthetic graft replacement.

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“…In case of Hope et al (2007)'s research group, the difference in flow patterns between healthy volunteers and ascending aortic aneurysm patients using time- As was stated in certain publications, in vitro (Morbiducci et al, 2007) and in vivo (Morbiducci et al, 2009) relates the detection of abnormalities in the expected physiological flow with the development of helicity in aorta, which occurs mainly to the asymmetry of blood flow. Gülan et al (2018) observed that counterclockwise helical flow patterns are developed from the ascending aorta and are extended towards the aortic arch in the healthy case. In the aneurysmal case, however, it was found formation of large rotational regions in the systolic phase, which shows qualitative similarity with vortex ring formation, mainly a central jet and two large vortices, seen in patients with ascending aortic aneurysms, as it was found in the study of Weigang et al (2008).…”

Section: Aorta´s Modelingmentioning

confidence: 93%

“…In the aneurysmal case, however, it was found formation of large rotational regions in the systolic phase, which shows qualitative similarity with vortex ring formation, mainly a central jet and two large vortices, seen in patients with ascending aortic aneurysms, as it was found in the study of Weigang et al (2008). From a fluid mechanical point of view, a sudden increase in diameter leads to a separation of the boundary layer and a separation bubble, and hence it is likely that there is an analogy between the separation, the associated turbulence and pressure loss and aneurysm growth (Gülan et al, 2018).…”

Section: Aorta´s Modelingmentioning

confidence: 99%

“…On the other hand, when the incoming jet from the aortic valve impinges at the aortic surface, it generates a high-pressure region. These phenomena may influence an aneurysm growth(Gülan et al, 2018).Once again, Patients 1 and 6 were selected to illustrate the flow behavior for patients with growth and no growth of an aortic aneurysm. The differential pressure in relation to the valve inlet ( − ) corresponding to Patient 1 is shown in Fig.…”

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Numerical Investigation of the Evolution of Blood Flow Patterns of Different Years in Patients With Ascending Aortic Aneurysm

ALMEIDA¹

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Blood flow patterns and pressure loss in the ascending aorta: A comparative study on physiological and aneurysmal conditions

Cited by 22 publications

References 27 publications

Performance analysis of the transcatheter aortic valve implantation on blood flow hemodynamics: An optical imaging‐based in vitro study

Performance analysis of the transcatheter aortic valve implantation on blood flow hemodynamics: An optical imaging‐based in vitro study

Utility of 4D Flow MRI in Thoracic Aortic Diseases: A Literature Review of Clinical Applications and Current Evidence

Numerical Investigation of the Evolution of Blood Flow Patterns of Different Years in Patients With Ascending Aortic Aneurysm

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