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.
Department of Mechanical Engineering, University College London, Torrington Place, London, WC1E 7JE, UK.
Ann Biomed Eng. 2020 Dec;48(12):2950-2964. doi: 10.1007/s10439-020-02603-z. Epub 2020 Sep 14.
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.
B 型主动脉夹层(AD)的最佳治疗方法仍存在争议,多达 50%的病例会发展为晚期并发症,需要进行有创干预。更好地了解 AD 的患者特定血液动力学特征,可以为疾病进展提供有用的见解,并支持临床管理。在这项工作中,提出了一种新的基于体外和计算的方法,使用非侵入性临床数据,对 AD 进行个体化研究。使用计算流体动力学(CFD)对 B 型 AD 进行了计算研究,使用最先进的体外模拟循环回路和粒子图像测速(PIV)进行了体外研究。这两种模型不仅复制了患者的解剖特征,还施加了生理准确和个体化的边界条件。在主动脉的不同位置,通过比较实验流量和压力波形以及通过 PIV 获得的详细速度场,与数值预测结果进行了广泛比较,吻合度极好。这项工作展示了如何协同开发实验和数值工具,以准确复制患者特定的 AD 血流。本文提出的联合平台是用于各种血管状况的先进血液动力学研究的有力工具,不仅可以验证 CFD 模型,还可以支持临床决策、手术规划和医疗设备创新。