The impact of left subclavian artery (LSA) coverage during thoracic endovascular aortic repair (TEVAR) on the circulatory system is not fully understood. Here, we coupled a single-phase non-Newtonian model with fluid–structure interaction (FSI) technique to simulate blood flow in an acute type B aortic dissection. Three-element Windkessel model was implemented to reproduce physiological pressure waves, where a new workflow was designed to determine model parameters with the absence of measured data. Simulations were carried out in three geometric models to demonstrate the consequence of TEVAR with the LSA coverage; case A: pre-TEVAR aorta; case B: post-TEVAR aorta with the disappearance of LSA; case C: post-TEVAR aorta with virtually adding LSA. Results show that the blood flow through the compressed true lumen is only 8.43%, which may lead to ischemia in related organs. After TEVAR, the wall pressure on the stented segment increases and blood flow in the supra-aortic branches and true lumen is improved. Meantime, the average deformation of the aorta is obviously reduced due to the implantation of the stent graft. After virtually adding LSA, significant changes in the distribution of blood flow and two indices based on wall shear stress are observed. Moreover, the movement of residual false lumen becomes stable, which could contribute to patient recovery. Overall, this study quantitatively evaluates the efficacy of TEVAR for acute type B aortic dissection and demonstrates that the coverage of LSA has a considerable impact on the important hemodynamic parameters.
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November 2019
Research-Article
A Primary Computational Fluid Dynamics Study of Pre- and Post-TEVAR With Intentional Left Subclavian Artery Coverage in a Type B Aortic Dissection
Yonghui Qiao,
Yonghui Qiao
State Key Laboratory of Clean Energy Utilization,
Zhejiang University,
38 Zheda Road,
Hangzhou 310027, China
e-mail: yhqiao@zju.edu.cn
Zhejiang University,
38 Zheda Road,
Hangzhou 310027, China
e-mail: yhqiao@zju.edu.cn
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Jianren Fan,
Jianren Fan
State Key Laboratory of Clean Energy Utilization,
Zhejiang University,
Hangzhou 310027, China
e-mail: fanjr@zju.edu.cn
Zhejiang University,
38 Zheda Road
,Hangzhou 310027, China
e-mail: fanjr@zju.edu.cn
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Ying Ding,
Ying Ding
Department of Radiology,
Zhongshan Hospital,
Fudan University,
Shanghai 200032, China
e-mail: ding.ying@zs-hospital.sh.cn
Zhongshan Hospital,
Fudan University,
180 Fenglin Road
,Shanghai 200032, China
e-mail: ding.ying@zs-hospital.sh.cn
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Ting Zhu,
Ting Zhu
Department of Vascular Surgery,
Zhongshan Hospital,
Fudan University,
Shanghai 200032, China
e-mail: zhu_ting@126.com
Zhongshan Hospital,
Fudan University,
180 Fenglin Road
,Shanghai 200032, China
e-mail: zhu_ting@126.com
1Corresponding authors.
Search for other works by this author on:
Kun Luo
Kun Luo
State Key Laboratory of Clean Energy Utilization,
Zhejiang University,
Hangzhou 310027, China
e-mail: zjulk@zju.edu.cn
Zhejiang University,
38 Zheda Road
,Hangzhou 310027, China
e-mail: zjulk@zju.edu.cn
1Corresponding authors.
Search for other works by this author on:
Yonghui Qiao
State Key Laboratory of Clean Energy Utilization,
Zhejiang University,
38 Zheda Road,
Hangzhou 310027, China
e-mail: yhqiao@zju.edu.cn
Zhejiang University,
38 Zheda Road,
Hangzhou 310027, China
e-mail: yhqiao@zju.edu.cn
Jianren Fan
State Key Laboratory of Clean Energy Utilization,
Zhejiang University,
Hangzhou 310027, China
e-mail: fanjr@zju.edu.cn
Zhejiang University,
38 Zheda Road
,Hangzhou 310027, China
e-mail: fanjr@zju.edu.cn
Ying Ding
Department of Radiology,
Zhongshan Hospital,
Fudan University,
Shanghai 200032, China
e-mail: ding.ying@zs-hospital.sh.cn
Zhongshan Hospital,
Fudan University,
180 Fenglin Road
,Shanghai 200032, China
e-mail: ding.ying@zs-hospital.sh.cn
Ting Zhu
Department of Vascular Surgery,
Zhongshan Hospital,
Fudan University,
Shanghai 200032, China
e-mail: zhu_ting@126.com
Zhongshan Hospital,
Fudan University,
180 Fenglin Road
,Shanghai 200032, China
e-mail: zhu_ting@126.com
Kun Luo
State Key Laboratory of Clean Energy Utilization,
Zhejiang University,
Hangzhou 310027, China
e-mail: zjulk@zju.edu.cn
Zhejiang University,
38 Zheda Road
,Hangzhou 310027, China
e-mail: zjulk@zju.edu.cn
1Corresponding authors.
Manuscript received April 28, 2018; final manuscript received May 20, 2019; published online July 30, 2019. Assoc. Editor: Sarah Kieweg.
J Biomech Eng. Nov 2019, 141(11): 111002 (7 pages)
Published Online: July 30, 2019
Article history
Received:
April 28, 2018
Revised:
May 20, 2019
Citation
Qiao, Y., Fan, J., Ding, Y., Zhu, T., and Luo, K. (July 30, 2019). "A Primary Computational Fluid Dynamics Study of Pre- and Post-TEVAR With Intentional Left Subclavian Artery Coverage in a Type B Aortic Dissection." ASME. J Biomech Eng. November 2019; 141(11): 111002. https://doi.org/10.1115/1.4043881
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