Finite element modeling of the thoracic aorta: including aortic root motion to evaluate the risk of aortic dissection

Abstract

Both aortic root displacement and hypertension significantly increase the longitudinal stress in the ascending aorta, which could play a decisive role in the development of various aortic pathologies, including aortic dissection.

Effects of aortic root motion on wall stress in the Marfan aorta before and after personalised aortic root support (PEARS) surgery

“…It is well-known that in most acute dissections of the ascending 43 aorta there is a transverse intimal tear a few centimetres distal to the aorto-ventricular 44 junction (Hirst et al, 1958). More recent studies have suggested that aortic root motion may 45 be a factor for occurrence of dissection and the site of the intimal tear due to increased 46 longitudinal wall stresses (Beller et al, 2004, Beller et al, 2008b. 47 48 Ventricular relaxation and contraction during every heartbeat provides a driving force for the 49 downward movement of the aortic annulus, which is then transmitted to the aortic root, 50 ascending aorta, transverse aortic arch and aortic branches.…”

“…This, along with observations of increasing 317 longitudinal stresses in aortic aneurysm growth, has led to the postulate that intimal tears in 318 the circumferential direction could be explained on the basis that the tear is caused by rapidly 319 increasing longitudinal stress on the inner surface of the aneurysm. Since aortic root motion 320 has been directly related to increased longitudinal stress, it has been identified as an 321 additional risk factor for aortic dissection (Beller et al, 2008b). Wrapping of the Marfan aorta 322 with the much stiffer PEARS has an obvious additional advantage in reducing aortic root 323 motion and ascending aorta deformation.…”

“…Other cardiac pathology also affected 55 aortic root movement, where patients with aortic insufficiency showed increased aortic root 56 motion because of increased left ventricular stroke volume while patients with left ventricular 57 systolic dysfunction displayed reduced aortic root motion because of reduced ventricular 58 contraction. 59 60 Stress analysis of the thoracic aorta was then carried out to investigate the influence of aortic 61 root motion on wall stress in the ascending aorta (Beller et al, 2004) and evaluate the risk of 62 aortic dissection (Beller et al, 2008b). A finite element (FE) model of an average adult 63 aortic wall, leading to stroke or other embolic events, or lead to accelerated degeneration of 89 homografts, autografts and bioprosthetic valves (Beller et al, 2008b).…”

“…59 60 Stress analysis of the thoracic aorta was then carried out to investigate the influence of aortic 61 root motion on wall stress in the ascending aorta (Beller et al, 2004) and evaluate the risk of 62 aortic dissection (Beller et al, 2008b). A finite element (FE) model of an average adult 63 aortic wall, leading to stroke or other embolic events, or lead to accelerated degeneration of 89 homografts, autografts and bioprosthetic valves (Beller et al, 2008b). Changes in the 90 magnitude of aortic root motion before and after aortic valve replacement (AVR) was 91 evaluated in patients with aortic insufficiency, aortic stenosis and proximal aortic dissection 92 (Beller et al, 2008a).…”

A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis

“…Finite element methods have been used extensively to study pressure vessels and other soft tissues (5,14,28). However, to the authors' knowledge, there have not been any finite element studies used to investigate mechanical behavior of the RLN.…”