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D'Ancona G.,Mediterranean Institute for Transplantation and Advanced Medical Therapies ISMETT | Amaducci A.,Mediterranean Institute for Transplantation and Advanced Medical Therapies ISMETT | Rinaudo A.,University of Palermo | Pasta S.,Fondazione Ri.MED | And 3 more authors.
Interactive Cardiovascular and Thoracic Surgery | Year: 2013

We present preliminary data on the flow-induced haemodynamic and structural loads exerted on a penetrating atherosclerotic aortic ulcer (PAU). Specifically, one-way fluid-structure interaction analysis was performed on the aortic model reconstructed from a 66-year-old male patient with a PAU that evolved into an intramural haematoma and rupture of the thoracic aorta. The results show that elevated blood pressure (117 mmHg) and low flow velocity at the aortic wall (0.15 m/s2) occurred in the region of the PAU. We also found a low value of time-averaged wall shear stress (1.24 N/m2) and a high value of the temporal oscillation in the wall shear stress (oscillatory shear index = 0.13) in the region of the PAU. After endovascular treatment, these haemodynamic parameters were distributed uniformly on the luminal surface of the stent graft. These findings suggest that wall shear stress could be considered one of the major haemodynamic factors indicating the structural fragility of the PAU wall, which ultimately lead to PAU growth and rupture. © The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. Source


Rinaudo A.,University of Palermo | D'Ancona G.,Mediterranean Institute for Transplantation and Advanced Medical Therapies ISMETT | Baglini R.,Mediterranean Institute for Transplantation and Advanced Medical Therapies ISMETT | Amaducci A.,Mediterranean Institute for Transplantation and Advanced Medical Therapies ISMETT | And 3 more authors.
Computer Methods in Biomechanics and Biomedical Engineering | Year: 2015

Coarctation of aorta (CoA) is a narrowing of the aorta leading to a pressure gradient (ΔP) across the coarctation, increased afterload and reduced peripheral perfusion pressures. Indication to invasive treatment is based on values of maximal (systolic) trans-coarctation ΔP. A computational fluid dynamic (CFD) approach is herein presented for the non-invasive haemodynamic assessment of ΔP across CoA. Patient-specific CFD simulations were created from contrast-enhanced computed tomography (CT) and appropriate flow boundary conditions. Computed ΔP was validated with invasive intravascular trans-CoA pressure measurements. Haemodynamic indices, including pressure loss coefficient (PLc), time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI), were also quantified. CFD-estimated ΔP values were comparable to the invasive ones. Moreover, the aorta proximal to CoA was exposed to altered TAWSS and OSI suggesting hypertension. PLc was found as a further geometric marker of CoA severity. Finally, CFD-estimated ΔP confirmed a significant reduction after percutaneous balloon dilatation and stenting of the CoA in one patient (e.g. from ΔP∼52 mmHg to ΔP∼3 mmHg). The validation of the ΔP computations with catheterisation measurements suggests that CFD simulation, based on CT-derived anatomical data, is a useful tool to readily quantify CoA severity. © 2015, © 2014 Taylor & Francis. Source

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