Effect of intimal flap motion on flow in acute type B aortic dissection by using fluid-structure interaction

Chong, Mei Yan and Gu, Boram and Chan, Bee Ting and Ong, Zhi Chao and Xu, Xiao Yun and Lim, Einly (2020) Effect of intimal flap motion on flow in acute type B aortic dissection by using fluid-structure interaction. International Journal for Numerical Methods in Biomedical Engineering, 36 (12). ISSN 2040-7939, DOI https://doi.org/10.1002/cnm.3399.

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A monolithic, fully coupled fluid-structure interaction (FSI) computational framework was developed to account for dissection flap motion in acute type B aortic dissection (TBAD). Analysis of results included wall deformation, pressure, flow, wall shear stress (WSS), von Mises stress and comparison of hemodynamics between rigid wall and FSI models. Our FSI model mimicked realistic wall deformation that resulted in maximum compression of the distal true lumen (TL) by 21.4%. The substantial movement of intimal flap mostly affected flow conditions in the false lumen (FL). Flap motion facilitated more flow entering the FL at peak systole, with the TL to FL flow split changing from 88:12 in the rigid model to 83:17 in the FSI model. There was more disturbed flow in the FL during systole (5.8% FSI vs 5.2% rigid) and diastole (13.5% FSI vs 9.8% rigid), via a lambda(2)-criterion. The flap-induced disturbed flow near the tears in the FSI model caused an increase of local WSS by up to 70.0% during diastole. This resulted in a significant reduction in the size of low time-averaged WSS (TAWSS) regions in the FL (113.11 cm(2)FSI vs 177.44 cm(2)rigid). Moreover, the FSI model predicted lower systolic pressure, higher diastolic pressure, and hence lower pulse pressure. Our results provided new insights into the possible impact of flap motion on flow in aortic dissections, which are particularly important when evaluating hemodynamics of acute TBAD. Novelty Statement Our monolithic fully coupled FSI computational framework is able to reproduce experimentally measured range of flap deformation in aortic dissection, thereby providing novel insights into the influence of physiological flap motion on the flow and pressure distributions. The drastic flap movement increases the flow resistance in the true lumen and causes more disturbed flow in the false lumen, as visualized through the lambda(2)criterion. The flap-induced luminal pressure is dampened, thereby affecting pressure measures, which may serve as potential prognostic indicators for late complications in acute uncomplicated TBAD patients.

Item Type: Article
Funders: Royal Society-Newton Advanced Fellowship [Grant No: NA170094]
Uncontrolled Keywords: Aortic dissection (AD); Computational fluid dynamics (CFD); Fluid-structure interaction (FSI); Intimal flap motion; Wall elasticity
Subjects: Q Science > QA Mathematics
T Technology > TA Engineering (General). Civil engineering (General)
Divisions: Faculty of Engineering > Biomedical Engineering Department
Faculty of Engineering > Department of Mechanical Engineering
Depositing User: Mrs. Siti Mawarni Salim
Date Deposited: 19 Sep 2022 02:40
Last Modified: 19 Sep 2022 02:40
URI: http://eprints.um.edu.my/id/eprint/31687

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