title: Blood flow dynamic improvement with aneurysm repair detected by a patient-specific model of multiple aortic aneurysms.
abstract: Aortic aneurysms may cause the turbulence of blood flow and result in the energy loss of the blood flow, while grafting of the dilated aorta may ameliorate these hemodynamic disturbances, contributing to the alleviation of the energy efficiency of blood flow delivery. However, evaluating of the energy efficiency of blood flow in an aortic aneurysm has been technically difficult to estimate and not comprehensively understood yet. We devised a multiscale computational biomechanical model, introducing novel flow indices, to investigate a single male patient with multiple aortic aneurysms. Preoperative levels of wall shear stress and oscillatory shear index (OSI) were elevated but declined after staged grafting procedures: OSI decreased from 0.280 to 0.257 (first operation) and 0.221 (second operation). Graftings may strategically counter the loss of efficient blood delivery to improve hemodynamics of the aorta. The energy efficiency of blood flow also improved postoperatively. Novel indices of pulsatile pressure index (PPI) and pulsatile energy loss index (PELI) were evaluated to characterize and quantify energy loss of pulsatile blood flow. Mean PPI decreased from 0.445 to 0.423 (first operation) and 0.359 (second operation), respectively; while the preoperative PELI of 0.986 dropped to 0.820 and 0.831. Graftings contributed not only to ameliorate wall shear stress or oscillatory shear index but also to improve efficient blood flow. This patient-specific modeling will help in analyzing the mechanism of aortic aneurysm formation and may play an important role in quantifying the energy efficiency or loss in blood delivery.
authors.affiliation: Department of Cardiac Surgery, The Royal Children's Hospital Melbourne, 50 Flemington Rd, Parkville, VIC, 3052, Australia, ksughimoto@gmail.com.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sughimoto
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Takahara
authors.forename: Kenji
authors.initials: K
authors.lastname: Mogi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Ken'ichi
authors.initials: K
authors.lastname: Tsubota
authors.forename: Fuyou
authors.initials: F
authors.lastname: Liang
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
mesh_terms: D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001696:Biomechanical Phenomena; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation; D003198:Computer Simulation; D004108:Dilatation, Pathologic; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome