Key result
Pre-dissection fluid dynamics link abnormal helical flow and elevated wall stress directly to intimal tear location.
Why the study?
The hemodynamic factors and wall stress patterns preceding type A aortic dissection in ascending aortic aneurysm with unicuspid aortic valve are not well characterized.
Does computational fluid dynamics analysis predict the site of intimal tear in ascending aortic aneurysms?
Case Report (n=1)
Does computational fluid dynamics analysis predict the site of intimal tear in ascending aortic aneurysms?
Computational fluid dynamics may help predict the specific site of intimal tear and risk of aortic dissection in patients with ascending aortic aneurysms.
CFD wall-stress mapping matched dissection site in one case; hypothesis-generating and requires prospective validation before any clinical use.
We performed a pre-dissection computational fluid analysis of an ascending aortic aneurysm associated with unicuspid aortic valve. The analysis showed an abnormal helical flow pattern inside the aneurysm and an increased wall stress on the right postero-lateral wall of the ascending aorta. These values were largely higher than the theoretical cut-off for aortic wall dissection, their topographic distribution followed the intimal tear site as subsequently diagnosed by computed tomography scan and confirmed during the operation for dissection repair.
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Malvindi et al. (2016) conducted a case report in Ascending aortic aneurysm associated with unicuspid aortic valve (n=1). Computational fluid analysis was evaluated on Flow pattern and wall stress. Pre-dissection computational fluid analysis of an ascending aortic aneurysm revealed abnormal helical flow and increased wall stress that topographically matched the subsequent intimal tear site.
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