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research-article

Impact of Patient-Specific Inflow Velocity Profile on Hemodynamics of the Thoracic Aorta

[+] Author and Article Information
Pouya Youssefi

Department of Cardiothoracic Surgery, St. George's Hospital, London SW17 0QT, UK; Department of Biomedical Engineering, King's College London, London SE1 7EH, UK
pyyoussefi@aol.com

Alberto Gomez

Department of Biomedical Engineering, King's College London, London SE1 7EH, UK
alberto.gomez@kcl.ac.uk

Christopher Arthurs

Department of Biomedical Engineering, King's College London, London SE1 7EH, UK
christopher.arthurs@kcl.ac.uk

Rajan Sharma

Department of Cardiology, St. George's Hospital, London SW17 0QT, UK
rajan.sharma@stgeorges.nhs.uk

Marjan Jahangiri

Department of Cardiothoracic Surgery, St. George's Hospital, London SW17 0QT, UK
marjan.jahangiri@stgeorges.nhs.uk

Alberto Figueroa

Department of Biomedical Engineering, King's College London, London SE1 7EH, UK; Departments of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109 USA
alberto.figueroa@kcl.ac.uk

1Corresponding author.

ASME doi:10.1115/1.4037857 History: Received July 28, 2016; Revised June 09, 2017

Abstract

Background-Computational fluid dynamics (CFD) provides a non-invasive method to functionally assess aortic hemodynamics. The thoracic aorta has an anatomically complex inlet comprising of the aortic valve, which is highly prone to different morphologies and pathologies. We investigated the effect of using patient-specific inflow velocity profiles compared to idealised profiles based on the patient's flow waveform. Methods-A healthy 31yo with a normally functioning tricuspid aortic valve (subject A), and a 52yo with a bicuspid aortic valve, aortic valvular stenosis and dilated ascending aorta (subject B) were studied. Subjects underwent MR angiography to image and reconstruct 3D geometric models of the thoracic aorta. Flow-MRI was acquired above the aortic valve and used to extract the patient-specific velocity profiles. Results-Subject B's eccentric asymmetrical inflow profile led to highly complex velocity patterns which were not replicated by the idealised velocity profiles. Despite having identical flow rates, the idealised inflow profiles displayed significantly different peak and radial velocities. Subject A's results showed some similarity between patient-specific and parabolic inflow profiles, however other parameters such as Flow-asymmetry were significantly different. Conclusion-Idealised inflow velocity profiles significantly alter velocity patterns and produce inaccurate hemodynamic assessments in the thoracic aorta. The complex structure of the aortic valve and its predisposition to pathological change means the inflow into the thoracic aorta can be highly variable. CFD analysis of the thoracic aorta needs to utilise fully patient-specific inflow boundary conditions in order to produce truly meaningful results.

Copyright (c) 2017 by ASME
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