Dimensional Analysis of Aortic Root Geometry During Diastole Using 3D Models Reconstructed from Clinical 64-Slice Computed Tomography Images

Wang, Qian; Book, Gregory; Contreras-Ortiz, Sonia H.; Primiano, Charles; McKay, Raymond G.; Kodali, Susheel; Sun, Wei

doi:10.1007/s13239-011-0052-8

Cited by 18 publications

(16 citation statements)

References 15 publications

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“…The semiautomatic segmentation and processing methods of medical imaging data were developed and used in our previous studies 27, 28 . The reconstructed geometries captured the LV internal structure and motion in detail, including the mitral annulus (MA) and proximal LA dynamics during the whole cardiac cycle.…”

Section: Methodsmentioning

confidence: 99%

Modeling Left Ventricular Blood Flow Using Smoothed Particle Hydrodynamics

Caballero

Mao

Liang

et al. 2017

Cardiovasc Eng Tech

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This study aims to investigate the capability of smoothed particle hydrodynamics (SPH), a fully Lagrangian mesh-free method, to simulate the bulk blood flow dynamics in two realistic left ventricular (LV) models. Three dimensional geometries and motion of the LV, proximal left atrium and aortic root are extracted from cardiac magnetic resonance imaging and multi-slice computed tomography imaging data. SPH simulation results are analyzed and compared with those obtained using a traditional finite volume-based numerical method, and to in vivo phase contrast magnetic resonance imaging and echocardiography data, in terms of the large-scale blood flow phenomena usually clinically measured. A quantitative comparison of the velocity fields and global flow parameters between the in silico models and the in vivo data shows a reasonable agreement, given the inherent uncertainties and limitations in the modeling and imaging techniques. The results indicate the capability of SPH as a promising tool for predicting clinically relevant large-scale LV flow information.

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Section: Methodsmentioning

confidence: 99%

Modeling Left Ventricular Blood Flow Using Smoothed Particle Hydrodynamics

Caballero

Mao

Liang

et al. 2017

Cardiovasc Eng Tech

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“…Aortic root was identified and separated from the rest of the chest images to create a 3D representation (Wang et al 2011). HyperMesh software (Altair Engineering, Inc., MI) was used to generate FE mesh of the 3D aortic root model (Figure 2), which included aortic root, aortic leaflets, calcification, mitral-aortic intervalvular fibrosa, anterior mitral leaflet, fibrous trigones, and left ventricle.…”

Section: Methodsmentioning

confidence: 99%

Simulations of transcatheter aortic valve implantation: implications for aortic root rupture

Wang

Kodali

Primiano

et al. 2014

Biomech Model Mechanobiol

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Objectives Aortic root rupture is one of the most severe complications of transcatheter aortic valve implantation (TAVI). The mechanism of this adverse event remains mostly unknown. The purpose of this study was to obtain a better understanding of the biomechanical interaction between the tissue and stent for patients with a high risk of aortic rupture. Methods We simulated the stent deployment process of three TAVI patients with high aortic rupture risk using finite element method. The first case was a retrospective analysis of an aortic rupture case, while the other two cases were prospective studies, which ended with one cancelled procedure and one successful TAVI. Simulation results were evaluated for the risk of aortic root rupture, as well as coronary artery occlusion, and paravalvular leak. Results For Case 1, the simulated aortic rupture location was the same as clinical observations. From the simulation results, it can be seen that the large calcified spot on the interior of the left coronary sinus between coronary ostium and the aortic annulus was pushed by the stent, causing the aortic rupture. For Case 2 and Case 3, predicated results from the simulations were presented to the clinicians at pre-procedure meetings; and they were in agreement with clinician’s observations and decisions. Conclusions Our results indicated that the engineering analysis could provide additional information to help clinicians evaluate complicated, high risk aortic rupture cases. Since a systematic study of a large patient cohort of aortic rupture is currently not available (due to the low occurrence rate) to clearly understand underlying rupture mechanisms, case by case engineering analysis is recommended for evaluating patient-specific aortic rupture risk.

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“…Engineering approaches may be used to improve procedural safety [1,26,29]. By combining high-resolution imaging techniques [42] and finite element (FE) analyses [35], virtual implantation of such devices is possible in order to understand the interaction of the device with the complex anatomical environment for individual patients. So-called patient-specific models of medical devices can play an important role in improving cardiovascular interventions.…”

Section: Introductionmentioning

confidence: 99%

Patient-specific simulations of transcatheter aortic valve stent implantation

Capelli

Bosi

Cerri

et al. 2012

Med Biol Eng Comput

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Transcatheter aortic valve implantation (TAVI) enables treatment of aortic stenosis with no need for open heart surgery. According to current guidelines, only patients considered at high surgical risk can be treated with TAVI. In this study, patient-specific analyses were performed to explore the feasibility of TAVI in morphologies, which are currently borderline cases for a percutaneous approach. Five patients were recruited: four patients with failed bioprosthetic aortic valves (stenosis) and one patient with an incompetent, native aortic valve. Three-dimensional models of the implantation sites were reconstructed from computed tomography images. Within these realistic geometries, TAVI with an Edwards Sapien stent was simulated using finite element (FE) modelling. Engineering and clinical outcomes were assessed. In all patients, FE analysis proved that TAVI was morphologically feasible. After the implantation, stress distribution showed no risks of immediate device failure and geometric orifice areas increased with low risk of obstruction of the coronary arteries. Maximum principal stresses in the arterial walls were higher in the model with native outflow tract. FE analyses can both refine patient selection and characterise device mechanical performance in TAVI, overall impacting on procedural safety in the early introduction of percutaneous heart valve devices in new patient populations.

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Dimensional Analysis of Aortic Root Geometry During Diastole Using 3D Models Reconstructed from Clinical 64-Slice Computed Tomography Images

Cited by 18 publications

References 15 publications

Modeling Left Ventricular Blood Flow Using Smoothed Particle Hydrodynamics

Modeling Left Ventricular Blood Flow Using Smoothed Particle Hydrodynamics

Simulations of transcatheter aortic valve implantation: implications for aortic root rupture

Patient-specific simulations of transcatheter aortic valve stent implantation

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