Andrzej Polanczyk
Medical University of Vienna, Austria
Title: A novel methodology for the description acute type IIIb aortic dissection treated in patients’ treated with TEVAR – numerical reconstruction of blood hemodynamic
Biography
Biography: Andrzej Polanczyk
Abstract
Introduction: The aim of the study was to reconstruct a blood hemodynamic for patients with type IIIb aortic dissection (TBAD) before and after thoracic endovascular aortic repair (TEVAR) with the use of computational fluid dynamics (CFD).
Methods: We prepared 3D models of the aorta with adjacent arteries using pre- and post-operative CT data from five patients treated for TBAD. Hemodynamic parameters (like, blood flow rate or wall shear stress (WSS)) were calculated with CFD technique. Results were verified with ultrasonography (USG) data.
Results: CFD indicated that TEVAR caused 7-fold improvement in overall blood flow through aorta (p=0.0001). Comparison of CFD and ultrasonography (USG) showed no significant change in blood flow through analysed arteries but a significant increase in flow rate for thoracic trunk and renal arteries, which was in accordance with USG (accuracy 90% and 99.9%). Moreover, we observed a significant decrease in wall shear stress (WSS) values within the whole aorta after-TEVAR compared to pre-TEVAR (1.34±0.20 Pa vs. 3.80±0.59 Pa; p=0.0001). This decrease was associated with a significant reduction in WSS in the thoracic
Conclusions: CFD technique denoted that post-operative remodeling of the aorta after TEVAR for TBAD improved
hemodynamic patterns reflected by flow, velocity and WSS with accuracy of 99%. Aorta (3.10±0.27Pa -1.34±0.11Pa; p=0.043) and renal arteries (4.40±0.25 Pa -1.50±0.22 Pa; p=0.043).