A Combined In Vivo , In Vitro , In Silico Approach for Patient-Specific Haemodynamic Studies of Aortic Dissection
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Annals of Biomedical Engineering (Ó 2020) https://doi.org/10.1007/s10439-020-02603-z
Original Article
A Combined In Vivo, In Vitro, In Silico Approach for Patient-Specific Haemodynamic Studies of Aortic Dissection MIRKO BONFANTI ,1 GAIA FRANZETTI ,2 SHERVANTHI HOMER-VANNIASINKAM ,1,2,3 VANESSA DI´AZ-ZUCCARINI ,1,2 and STAVROULA BALABANI 2 1
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), Department of Medical Physics and Biomedical Engineering, University College London, 43-45 Foley Street, London W1W 7TS, UK; 2Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK; and 3Leeds Teaching Hospitals NHS Trust, Great George Street, Leeds LS1 3EX, UK (Received 18 June 2020; accepted 2 September 2020) Associate Editor Lakshmi Prasad Dasi oversaw the review of this article.
Abstract—The optimal treatment of Type-B aortic dissection (AD) is still a subject of debate, with up to 50% of the cases developing late-term complications requiring invasive intervention. A better understanding of the patient-specific haemodynamic features of AD can provide useful insights on disease progression and support clinical management. In this work, a novel in vitro and in silico framework to perform personalised studies of AD, informed by non-invasive clinical data, is presented. A Type-B AD was investigated in silico using computational fluid dynamics (CFD) and in vitro by means of a state-of-the-art mock circulatory loop and particle image velocimetry (PIV). Both models not only reproduced the anatomical features of the patient, but also imposed physiologically-accurate and personalised boundary conditions. Experimental flow rate and pressure waveforms, as well as detailed velocity fields acquired via PIV, are extensively compared against numerical predictions at different locations in the aorta, showing excellent agreement. This work demonstrates how experimental and numerical tools can be developed in synergy to accurately reproduce patient-specific AD blood flow. The combined platform presented herein constitutes a powerful tool for advanced haemodynamic studies for a range of vascular conditions, allowing not only the validation of CFD models, but also clinical decision support, surgical planning as well as medical device innovation.
Address correspondence to Vanessa Dı´ az-Zuccarini, and Stavroula Balabani, Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK. Electronic mails: [email protected], [email protected]
Keywords—Aortic dissection, Particle image velocimetry, Blood flow, Computational fluid dynamics, Pulsatile flow, Patient-specific.
ABBREVIATIONS AD FL TL IF CFD PIV 3WK WSS BC R C RI TAWSS FSI PC-MRI CT LSA BT LCC DA CO SV SST RANS
Aortic dissection False lumen True lumen Intimal flap Computational fluid dynamics Particle image velocimetry 3-Element Windkessel model Wall shear stress Boundary condition Resistance Compliance Refractive index Time-averaged wall shear stress Fluid structure interaction Phase-c
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