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Prediction of aortic dilatation in surgically repaired type A dissection: A longitudinal study using computational fluid dynamics.


ABSTRACT:

Objective

To examine the role of a key hemodynamic parameter, namely the true and false lumen pressure difference, to predict progressive aortic dilatation following type A aortic dissection (TAAD) repair.

Methods

Four patients with surgically repaired TAAD with multiple follow-up computed tomography angiography scans (4-5 scans per patient; N = 18) were included. Through-plane diameter of the residual native thoracic aorta was measured in various aortic segments during the follow up period (mean follow-up: 49.6 ± 31.2 months). Computational flow analysis was performed to estimate true and false lumen pressure difference at the same locations and the correlation with aortic size change was studied using a linear mixed effects model.

Results

Greater pressure difference between the true and false lumen was consistent with greater aortic diameter expansion during the follow up period (linear mixed effects analysis; coefficient, 0.26; 95% confidence interval, 0.15-0.37; P < .001). Based on our limited data points, a pressure difference higher than 5 mm Hg might cause unstable aortic growth.

Conclusions

Computational fluid dynamic assessment of standard aortic computed tomography angiography offers a noninvasive technique that predicts the risk of aortic dilatation following TAAD. The technique may be used to plan closer observation or intervention in high-risk patients.

SUBMITTER: Zhu Y 

PROVIDER: S-EPMC9390758 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Prediction of aortic dilatation in surgically repaired type A dissection: A longitudinal study using computational fluid dynamics.

Zhu Yu Y   Xu Xiao Yun XY   Rosendahl Ulrich U   Pepper John J   Mirsadraee Saeed S  

JTCVS open 20220209


<h4>Objective</h4>To examine the role of a key hemodynamic parameter, namely the true and false lumen pressure difference, to predict progressive aortic dilatation following type A aortic dissection (TAAD) repair.<h4>Methods</h4>Four patients with surgically repaired TAAD with multiple follow-up computed tomography angiography scans (4-5 scans per patient; N = 18) were included. Through-plane diameter of the residual native thoracic aorta was measured in various aortic segments during the follow  ...[more]

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