title: Patient-specific finite element analysis of ascending aorta aneurysms.
abstract: Catastrophic ascending aorta aneurysm (AsAA) dissection and rupture can be prevented by elective surgical repair, but identifying individuals at risk remains a challenge. Typically the decision to operate is based primarily on the overall aneurysm size, which may not be a reliable indicator of risk. In this study, AsAA inflation and rupture was simulated in 27 patient-specific finite element models constructed from clinical CT imaging data and tissue mechanical testing data from matching patients. These patients included n = 8 with concomitant bicuspid aortic valve (BAV), n = 10 with bovine aortic arch (BAA), and n = 10 with neither BAV nor BAA. AsAA rupture risk was found to increase with elevated systolic wall stress and tissue stiffness. The aortic size index was sufficient for identifying the patients with the lowest risk of rupture, but unsuitable for delineating between patients at moderate and high risk. There was no correlation between BAV or BAA and AsAA rupture risk; however, the AsAA morphology was different among these patients. These results support the use of mechanical parameters such as vessel wall stress and tissue stiffness for AsAA presurgical evaluation.
authors.affiliation: Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia; and.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Martin
authors.affiliation: Tissue Mechanics Laboratory, The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia; and wei.sun@bme.gatech.edu.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Aortic Institute of Yale-New Haven Hospital, Yale University, New Haven, Connecticut.
authors.forename: John
authors.initials: J
authors.lastname: Elefteriades
mesh_terms: D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001019:Aortic Rupture / Q000517:prevention & control; D020342:Finite Element Analysis; D006801:Humans; D066230:Patient-Specific Modeling; D012984:Software; D013526:Surgical Mesh; D014055:Tomography, Emission-Computed
keywords: aortic rupture; ascending aorta aneurysm; bicuspid aortic valve; bovine aortic arch; finite element