Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models

Figures

• 

  Figure 1. (A) Idealized aortic arch model. (B) Aorta models reconstructed from computed tomography (CT) scan images. The label indicates a curvature angle in each patient which is defined as sum of curve and torsion angles and indicative of global 3D curvature of aorta. (C) Curve angle of aorta or 180° − ϕ is defined as an angle made at the peak position of the inner aortic curve as projected onto the rough mid-plane passing through two centroid points of ascending aorta inlet and descending aorta outlet based on the previous study35. The black arrow in the left panel denotes a normal vector perpendicular to the mid-plane. Dashed line indicates a rough center line of aorta. (D) Torsion angle or 180° − θ which is defined as an angle at the left common carotid artery that is made by connecting three centroid points of ascending aorta, left common carotid artery, and descending aorta as projected in the descending aorta direction.

• 

  Figure 2. Distribution of clots within the idealized aorta model at the end of second systolic stage of a normal cardiac cycle after release of clots at the aortic inlet with application of (A) drag force + buoyancy force (B) drag force + buoyancy force + virtual mass force (C) drag force + buoyancy force + pressure gradient force, and (D) drag force + buoyancy force + virtual mass force + pressure gradient force on the clot.

• 

  Figure 3. Distribution of clots at the peak stage of second cardiac cycle after released at the aortic inlet subject to the (A) normal and (B) AF flow condition within the aorta model reconstructed from patient 1 to 5.

• 

  Figure 4. Stroke propensity through LCCA for various ejection instances (i.e., accelerating, peak, and decelerating stage of a cardiac cycle) and overall stroke propensity for various aorta models from (A) patient 1, 2, and 3 and (B) patient 4 and 5.

• 

  Figure 5. (A) Stroke propensity with curvature angle under the normal and AF flow condition. (B) Stroke propensity alteration induced by AF with curvature angle compared to the normal flow condition.

• 

  Figure 6. Pressure distribution with a cardiac cycle from accelerating or 0.25Tsys (solid lines) to peak or 0.5Tsys (dashed lines) and decelerating or 0.75Tsys (dashed dot lines) stage along the aorta center line relative to the descending aorta outlet as shown in Fig. 1C under the normal and AF flow condition in (A) patient 1, 2, and 3 and (B) patient 4 and 5. Thick and thin line denote the normal and AF flow condition, respectively. Tsys denotes the systolic period of a cardiac cycle.