Impact of Patient-Specific Inflow Velocity Profile on Hemodynamics of the Thoracic Aorta

Author:

Youssefi Pouya12,Gomez Alberto2,Arthurs Christopher2,Sharma Rajan3,Jahangiri Marjan4,Alberto Figueroa C.56

Affiliation:

1. Department of Cardiothoracic Surgery, St. George's Hospital, London SW17 0QT, UK;

2. Department of Biomedical Engineering, King's College London, London SE1 7EH, UK e-mail:

3. Department of Cardiology, St. George's Hospital, London SW17 0QT, UK e-mail:

4. Department of Cardiothoracic Surgery, St. George's Hospital, London SW17 0QT, UK e-mail:

5. Department of Biomedical Engineering, King's College London, London SE1 7EH, UK;

6. Departments of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109 e-mail:

Abstract

Computational fluid dynamics (CFD) provides a noninvasive method to functionally assess aortic hemodynamics. The thoracic aorta has an anatomically complex inlet comprising of the aortic valve and root, which is highly prone to different morphologies and pathologies. We investigated the effect of using patient-specific (PS) inflow velocity profiles compared to idealized profiles based on the patient's flow waveform. A healthy 31 yo with a normally functioning tricuspid aortic valve (subject A), and a 52 yo with a bicuspid aortic valve (BAV), aortic valvular stenosis, and dilated ascending aorta (subject B) were studied. Subjects underwent MR angiography to image and reconstruct three-dimensional (3D) geometric models of the thoracic aorta. Flow-magnetic resonance imaging (MRI) was acquired above the aortic valve and used to extract the patient-specific velocity profiles. Subject B's eccentric asymmetrical inflow profile led to highly complex velocity patterns, which were not replicated by the idealized velocity profiles. Despite having identical flow rates, the idealized inflow profiles displayed significantly different peak and radial velocities. Subject A's results showed some similarity between PS and parabolic inflow profiles; however, other parameters such as Flowasymmetry were significantly different. Idealized inflow velocity profiles significantly alter velocity patterns and produce inaccurate hemodynamic assessments in the thoracic aorta. The complex structure of the aortic valve and its predisposition to pathological change means the inflow into the thoracic aorta can be highly variable. CFD analysis of the thoracic aorta needs to utilize fully PS inflow boundary conditions in order to produce truly meaningful results.

Funder

H2020 European Research Council

British Heart Foundation

Royal College of Surgeons of England

Publisher

ASME International

Subject

Physiology (medical),Biomedical Engineering

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