title: Functional assessment of thoracic aortic aneurysms - the future of risk prediction?
abstract: Treatment guidelines for the thoracic aorta concentrate on size, yet acute aortic dissection or rupture can occur when aortic size is below intervention criteria. Functional imaging and computational techniques are a means of assessing haemodynamic parameters involved in aortic pathology.
  
  
  
  Original articles, reviews, international guidelines.
  
  
  
  Computational fluid dynamics and 4D flow MRI allow non-invasive assessment of blood flow parameters and aortic wall biomechanics.
  
  
  
  Aortic valve morphology (particularly bicuspid aortic valve) is associated with aneurysm of the ascending aorta, although the exact mechanism of aneurysm formation is not yet established.
  
  
  
  Haemodynamic assessment of the thoracic aorta has highlighted parameters which are linked with both clinical outcome and protein changes in the aortic wall. Wall shear stress, flow displacement and helicity are elevated in patients with bicuspid aortic valve, particularly at locations of aneurysm formation.
  
  
  
  With further validation, functional assessment of the aorta may help identify patients at risk of aortic complications, and introduce new haemodynamic indices into management guidelines.
authors.affiliation: Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom.|Department of Biomedical Engineering, Rayne Institute, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom.
authors.forename: Pouya
authors.initials: P
authors.lastname: Youssefi
authors.affiliation: Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom.
authors.forename: Rajan
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Biomedical Engineering, Rayne Institute, St. Thomas' Hospital, King's College London, London SE1 7EH, United Kingdom.|Departments of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109 USA.
authors.forename: C Alberto
authors.initials: CA
authors.lastname: Figueroa
authors.affiliation: Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom.
authors.forename: Marjan
authors.initials: M
authors.lastname: Jahangiri
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000473:pathology; D000082882:Bicuspid Aortic Valve Disease; D001783:Blood Flow Velocity; D057791:Cardiac Imaging Techniques; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests
keywords: MRI; aorta; aortic valve; computational fluid dynamics; dissection; wall shear stress