Computational Fluid Dynamics and Aortic Thrombus Formation Following Thoracic Endovascular Aortic Repair Foeke J.H. Nauta, MD, PhD, Kevin D. Lau, PhD,

Slides:

Advertisements

Similar presentations

Protocol implementation of selective postoperative lumbar spinal drainage after thoracic aortic endograft Charles J. Keith, BA, Marc A. Passman, MD,

Advertisements

Endovascular treatment of thoracic aortic aneurysms with a short proximal landing zone using scalloped endografts Ali Alsafi, MBBS, BSc (Hons), Colin.

Open Distal Fenestration of Chronic Dissection Facilitates Endovascular Elephant Trunk Completion: Late Outcomes Muhammad Aftab, MD, Jay J. Idrees, MD,

Successful Treatment of Infected Ascending Aortic Prosthesis by Omental Wrapping Without Graft Removal Gordan Samoukovic, MD, Pierre-Luc Bernier, MD,

Rana O. Afifi, MD, Harith H. Mushtaq, MD, Harleen K

Acute blunt traumatic injury to the descending thoracic aorta

Fenestrated endovascular repair of aortic arch aneurysm in patients with bovine arch using the Najuta stent graft Naoki Toya, MD, PhD, Takao Ohki, MD,

Branched Endovascular Therapy of the Distal Aortic Arch: Preliminary Results of the Feasibility Multicenter Trial of the Gore Thoracic Branch Endoprosthesis

Repair of Coarctation in Right Circumflex Retroesophageal Arch

Jacques Kpodonu, MD, Venkatesh G. Ramaiah, MD, Edward B. Diethrich, MD

Randall R. De Martino, MD, MS, Jill Johnstone, MD, Elizabeth A

Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm Ludovic.

Giant Aortic Thrombus in the Ascending Aorta and Perforation of Bowel Associated With Cocaine Use Shi Sum Poon, MBChB, Omar Nawaytou, MD, Alfred Hing,

Ourania Preventza, MD, James J. Livesay, MD, Denton A

Leon M. Ptaszek, MD, PhD, Kibeom Kim, BA, Amy E. Spooner, MD, Thomas E

Management of Type A Aortic Dissection and a Large Pheochromocytoma: A Surgical Dilemma Frank W. Bowen, MD, Jessie Civan, BS, Anton Orlin, BS, Thomas.

Value of Magnetic Resonance Imaging, Angiography, and Fractional Flow Reserve to Evaluate the Left Main Coronary Artery After Direct Surgical Angioplasty

Stented Elephant Trunk Technique for Retrograde Type A Aortic Dissection After Endovascular Stent Graft Repair Bin Li, MD, Xu-Dong Pan, MD, Wei-Guo Ma,

Christopher D. Bayliss, BMBS, BMedSci, Karen L

Repair of Circumflex Aortic Arch in an Adult

Aneurysms After Coarctation Repair Associated With Hypoplastic Aortic Arch: Surgical Management Through Median Sternotomy Davide Pacini, MD, Marcello.

Thoracic Endovascular Aortic Repair Including Total Debranching on Femoral Artery for Arch Rupture Yu Inaba, MD, Tsutomu Ito, MD, PhD, Sachiko Hayashi,

Total Endovascular Repair of an Aortic Arch Aneurysm Using an Externalized Transseptal Guidewire Technique Pascal Rheaume, MD, Paolo Perini, MD, Mickael.

Surgical Resection of a Giant Coronary Aneurysm

Guido H. W. van Bogerijen, MD, Himanshu J. Patel, MD, Jonathan L

Risk Factors of Neurologic Deficit After Thoracic Aortic Endografting

Ganesh S. Kumpati, MD, Robert Gray, MD, Amit Patel, MD, David A

Selective Left Subclavian Ligation in Total Aortic Arch Replacement

Thoracic Stent Grafting for Acute Aortic Pathology

Acute retrograde aortic dissection during endovascular repair of a thoracic aortic aneurysm Noëlla Bethuyne, MD, Thierry Bove, MD, Pierre Van den Brande,

Endovascular repair of a thoracic aortic aneurysm in pregnancy at 22 weeks of gestation Veer Chahwala, MD, Jun Tashiro, MD, MPH, Atif Baqai, MD, Edward.

Thoracic endovascular aortic repair of aortobronchial fistulas

Surgical Dilemmas: Diagnosis and Treatment of Atrial Plasmacytoma

Effects of False Lumen Procedures on Aorta Remodeling of Chronic DeBakey IIIb Aneurysm Tae-Hoon Kim, MD, Suk-Won Song, MD, PhD, Kwang-Hun Lee, MD, PhD,

Staged hybrid approach using proximal thoracic endovascular aneurysm repair and distal open repair for the treatment of extensive thoracoabdominal aortic.

Sanford M. Zeigler, MD, William Hiesinger, MD

How to Clamp and Bypass if There Is Single Artery Supply to the Head and That Contains Severe Stenosis? Murat Ugurlucan, MD, Yilmaz Onal, MD, Didem Melis.

Hybrid repair of an aortic arch aneurysm with complex anatomy: Right aortic arch and anomalous origin of supra-aortic vessels Roberto Chiesa, MD, Germano.

Foeke J. H. Nauta, MD, Jip L. Tolenaar, MD, PhD, Himanshu J

Open, Hybrid, and Endovascular Treatment for Aortic Coarctation and Postrepair Aneurysm in Adolescents and Adults Eric E. Roselli, MD, Athar Qureshi,

Endovascular Repair of a Right-Sided Descending Thoracic Aortic Aneurysm With a Right-Sided Aortic Arch and Aberrant Left Subclavian Artery Joseph J.

Endovascular Treatment of a Thoracic Aortic Pseudoaneurysm After Previous Open Repair Derek R. Brinster, MD, Desirae M. McKee, MD, Dawn M. Olsen, PA,

Sebastian Pagni, MD, Jaimin Trivedi, MD, MPH, Brian L

Endovascular Repair of Ruptured Aberrant Left Subclavian Artery With Right Aortic Arch Manabu Motoki, MD, Koji Hattori, MD, Yasuyuki Kato, MD, Yosuke.

Rapid Aortic Arch Debranching Using the Gore Hybrid Vascular Graft

Total Endovascular Repair of Post-dissection Aortic Arch Aneurysm With Chimney Technique Wei-Tao Liang, MD, Su Wang, MD, Jian Zhou, MD, Chen-Jun Han,

Clinical Significance of Intraluminal Atheroma in Patients With Ascending and Arch Aneurysm Jihang Kim, MD, Sang Il Choi, MD, Kay-Hyun Park, MD, Eun.

E. Dean McKenzie, MD, Mark E. Roeser, MD, Jess L. Thompson, MD, Luis E

Mycotic Aneurysm of the Descending Thoracic Aorta in a 2-kg Neonate

Hybrid Repair of Subclavian-Axillary Artery Aneurysms and Aortic Arch Aneurysm in a Patient With Marfan Syndrome Akihiro Yoshitake, MD, PhD, Hideyuki.

Anirudh Vinnakota, MS, Robert Stewart, MD, Gosta Pettersson, MD, PhD

Double-Barreled Cannon Stent Grafts: Possible Solution for Extremely Dilated Landing Zone of Aorta Yi-Hsuan Wu, MD, Cheng-Che Tseng, MD, Tzong-Nan Kuo,

Mycotic Aneurysm of the Aortic Arch Presenting With Left Vocal Cord Palsy George Tokmaji, Igor Gosev, MD, Kanako Kunishima Kumamaru, MD, PhD, Ralph Morton.

Pregnancy-Associated Type B Aortic Dissection Treated With Thoracic Endovascular Aneurysm Repair Chang Shu, MD, PhD, Kun Fang, MD, Alan Dardik, MD, PhD,

G. Chad Hughes, MD, Asvin M. Ganapathi, MD, Jeffrey E

Shelby Kutty, MD, Roy K. Greenberg, MD, Scott Fletcher, MD, Lars G

Endovascular repair of a Kommerell's diverticulum in a patient with a left-sided aortic arch and right-sided descending thoracic aorta Paul J. Riesenman,

Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian.

Combined Endovascular and Surgical Procedure for Recurrent Thoracoabdominal Aortic Aneurysm Masato Yoshida, MD, Nobuhiko Mukohara, MD, Tsutomu Shida,

Yangfeng Tang, MD, Zilin Liao, MD, Lin Han, MD, Zhiyun Xu, MD

Traumatic Partial Avulsion of a Single Right Subclavian Artery from the Aortic Arch and Definitive Repair Emmanouil I. Kapetanakis, MD, Pamela Sears-Rogan,

Hybrid Arch Repair Including Supra-Aortic Debranching on the Descending Aorta Hideyuki Shimizu, MD, PhD, Takashi Hachiya, MD, Kentaro Yamabe, MD, Ryohei.

The Annals of Thoracic Surgery

Endovascular repair of a type B aortic dissection with a ventricular septal defect occluder Guangqi Chang, MD, Huishen Wang, MD, Wei Chen, MD, Chen Yao,

Bicuspid Aortic Valves and Dilatation of the Ascending Aorta: Reply

Michael P. Jenkins, MD, Stéphan Haulon, MD, PhD, Roy K

Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta Gabriele Piffaretti, MD, PhD, Mario Galli, MD, Chiara Lomazzi, MD,

Faisal G. Bakaeen, MD, Joseph S. Coselli, MD, Scott A

Endoleaks after endovascular repair of thoracic aortic aneurysms

Ascending Aortic Extension for Enlargement of the Aortopulmonary Space in Children with Pulmonary Artery Stenosis Craig J. Baker, MD, Winfield J. Wells,

Presentation transcript:

Computational Fluid Dynamics and Aortic Thrombus Formation Following Thoracic Endovascular Aortic Repair Foeke J.H. Nauta, MD, PhD, Kevin D. Lau, PhD, Christopher J. Arthurs, PhD, Kim A. Eagle, MD, David M. Williams, MD, Santi Trimarchi, MD, PhD, Himanshu J. Patel, MD, Carlos A. Figueroa, PhD The Annals of Thoracic Surgery Volume 103, Issue 6, Pages 1914-1921 (June 2017) DOI: 10.1016/j.athoracsur.2016.09.067 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Patient history showing (A) ascending aortic aneurysm which was repaired with a (B) surgical graft in 2012. (C) Paraanastomosis aneurysm dilatation 3 years postoperatively, which was treated with (D) TEVAR in December 2015. (E) Computed tomography angiography 1 month post-TEVAR suggested intraluminal thrombus at the proximal endograft end, as indicated by the red circle. (F) Magnetic resonance imaging confirmed ascending aortic thrombus, as marked by the red circle. The kink in the endograft is denoted with the blue circle. (TEVAR = thoracic endovascular aortic repair.) The Annals of Thoracic Surgery 2017 103, 1914-1921DOI: (10.1016/j.athoracsur.2016.09.067) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Models of the different aortic geometries. From left to right: the baseline aortic geometry, the ascending aortic surgical repair, the conformable endograft, and the single-branched endograft into the LSA. (LSA = left subclavian artery.) The Annals of Thoracic Surgery 2017 103, 1914-1921DOI: (10.1016/j.athoracsur.2016.09.067) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Pressure (black lines) and flow waveforms (red lines) computed at thoracic aorta inflow and different branch outlets. The location of each measurement is denoted by a number. The Annals of Thoracic Surgery 2017 103, 1914-1921DOI: (10.1016/j.athoracsur.2016.09.067) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Computed tomography imaging showing the aortic thrombus (red circle). (B–E) Particles and their corresponding PLAP value are shown at the end of the second cardiac cycle. Average PLAP are given for each model for both the aortic arch ROI (denoted within the two dashed lines) as well as for the thrombus location ROI (marked with a black circle). (B) Baseline aortic geometry, (C) aortic surgical repair, (D) conformable endograft, and (E) single-branched endograft. One-way analysis of variance testing calculated p < 0.001 for PLAP differences among the four models in both ROI. See the Video for a dynamic visualization of PLAP in each model. Values are presented as mean ± SD. (PLAP = platelet activation potential; ROI = region of interest.) The Annals of Thoracic Surgery 2017 103, 1914-1921DOI: (10.1016/j.athoracsur.2016.09.067) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Computed tomography at baseline and at 18 weeks follow-up demonstrating stable three-dimensional volumes of the intraaortic thrombus. The Annals of Thoracic Surgery 2017 103, 1914-1921DOI: (10.1016/j.athoracsur.2016.09.067) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions