Longitudinal computational fluid dynamics study of aneurysmal dilatation in a chronic DeBakey type III aortic dissection Christof Karmonik, PhD, Sasan.

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Date of download: 10/9/2017 Copyright © ASME. All rights reserved.

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Longitudinal computational fluid dynamics study of aneurysmal dilatation in a chronic DeBakey type III aortic dissection Christof Karmonik, PhD, Sasan Partovi, MD, Matthias Müller-Eschner, MD, Jean Bismuth, MD, Mark G. Davies, MD, Dipan J. Shah, MD, Matthias Loebe, MD, Dittmar Böckler, MD, Alan B. Lumsden, MD, Hendrik von Tengg-Kobligk, MD Journal of Vascular Surgery Volume 56, Issue 1, Pages 260-263.e1 (July 2012) DOI: 10.1016/j.jvs.2012.02.064 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Top, In this schematic of velocity waveform within the ascending aorta, the black circles mark intervals 1 to 4 where intraluminal cross sections are shown. Bottom, Rows show through-plane two-dimensional phase-contrast magnetic resonance imaging (pcMRI) velocity magnitudes and intraluminal cross sections from computational fluid dynamics (CFD). The arrow marks similar features; in particular, a helical flow pattern of inflowing blood (black) can be appreciated in the ascending aorta (open arrows). During systole (2), predominantly antegrade flow in the false lumen can be appreciated (filled arrows); at other time points, flow patterns are more complex, showing different degrees of antegrade (dark) and retrograde (bright) flow in the false lumen. Journal of Vascular Surgery 2012 56, 260-263.e1DOI: (10.1016/j.jvs.2012.02.064) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A, The location of slow, recirculating flow (posterior thoracic false lumen wall) coincided with the presence of a thrombotic formation observed with magnetic resonance imaging (MRI) during the initial examination on a two-dimensional phase-contrast MRI (pcMRI) magnitude image (left) and a postcontrast parasagittal image indicating lack of enhancement (right, open arrows). B, Temporal variation of total pressure (in 1000-Pa increments) during the cardiac cycle at initial examination (blue) and follow-up (red) at three anatomic locations: ascending aorta and true and false lumens. Pronounced differences for initial presentation and follow-up can be appreciated in all three locations during systolic (*) and diastolic (†) flow. In contrast, total pressure values were essentially identical during diastole (‡). C, Pseudocolor presentation (top) shows the average total pressure on the luminal wall of the three-dimensional model during systole (ie, peak pressure in Pa) at the initial examination (IE) and follow-up (FU). A decrease of total pressure can be appreciated at follow-up, in particular at the posterior false lumen wall (white arrows). Wall shear stress during systole (bottom). Low wall shear stress is present at the posterior wall of the false lumen (<2.5 Pa) at both examinations (white arrows). Journal of Vascular Surgery 2012 56, 260-263.e1DOI: (10.1016/j.jvs.2012.02.064) Copyright © 2012 Society for Vascular Surgery Terms and Conditions