Thesis
Employing computational modeling to guide surgical treatment of aortic dissections
University of Iowa
Master of Science (MS), University of Iowa
Summer 2021
DOI: 10.17077/etd.005973
Abstract
An aortic dissection (AD) is a complex, life threatening disease. The initiating event that contributes to an aortic dissection is the structural weakness of the arterial wall leading to tearing of the arterial layers which can cause rupture. An AD is classified based on anatomical characteristics, the first of the two is Type A, containing the ascending aorta, and the second is Type B, originating in the descending aorta. In a dissection, two passageways can form, a true lumen where blood flows, and a false lumen where blood flow is redirected diverting flow from the true lumen. Rapid team management for aortic dissections is dependent upon patient symptoms. The patient diagnosis, which is observed with imaging techniques, aid in clinical treatment. Treatment may include drug therapy for patients with manageable dissections, or for dissections with greater risk and complication open heart surgery or endovascular repair will be required.
Aortic dissections vary greatly from patient-to-patient and affect diagnosis and treatment accordingly. The management decisions for patients are dependent on a multitude of factors such as patient physiology, health background, the location of a dissection, and the extent of a dissection. The multitude of decisions and considerations to be made bring a lack of clinical consensus in aortic dissection management and treatment.
To address this problem, this research project investigates the applications of computational fluid dynamics (CFD) through three-dimensional (3D) simulations using patient-specific data. This data will quantify changes in hemodynamic parameters to observe fluid flow, wall shear stress (WSS), pressure, and velocity magnitude. This effort will aid in the prediction of dissection degeneration, progression, and clinical significance.
Details
- Title: Subtitle
- Employing computational modeling to guide surgical treatment of aortic dissections
- Creators
- Jennifer Mount
- Contributors
- Sarah C Vigmostad (Advisor)Seth Dillard (Committee Member)M L Raghavan (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Biomedical Engineering
- Date degree season
- Summer 2021
- DOI
- 10.17077/etd.005973
- Publisher
- University of Iowa
- Number of pages
- ix, 61 pages
- Copyright
- Copyright 2021 Jennifer Mount
- Language
- English
- Description illustrations
- color illustrations
- Description bibliographic
- Includes bibliographical references (pages 46-49)
- Public Abstract (ETD)
An aortic dissection (AD) occurs in 5-30 cases per 1 million people per year classifying this disease to be rare. Though this disease may be rare, it can become an urgent medical emergency and potentially fatal. The aorta consists of three layers, an inner layer, middle layer, and an outer layer. When there is an aortic dissection present, the innermost layer has been injured redirecting blood flow between the other layers of the aorta leading to the separation of the layers and possible tear. To observe the blood flow in an AD, cardiovascular computational fluid dynamics (CFD) can be used. CFD has become a widespread technique in the research healthcare field because of the multi-modal applications. CFD has the capabilities to aid physicians in non-invasive decision making, examine patient-specific modeling, make critical decisions in diagnosis, surgical planning, 3D data processing and visualization, and contributes to medical device design.
To address an AD there are two main treatments, the first is medication to prevent the AD from worsening and the second option is surgery. In a surgical procedure, the objective is to manage the damaged vessel through repair to restore blood flow. However, depending on the location of the tear and the extent that has been damaged, there is debate on what sections to repair, how much, and the patient’s repercussions that might reside post operation.
In this research project I explore fluid flow in aortic dissections by using CFD modeling to explore surgical treatment strategies.
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering
- Record Identifier
- 9984124472202771
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