Computational analysis of fluid dynamics at the ascending thoracic aorta in Marfan syndrome patients


Pons Cots, Ramon 


Aortic aneurysms are a progressive and irreversible dilation of the aortic wall, which can lead to vessel rupture or dissection, resulting in catastrophic blood loss leading to death. Initial pharmacological treatment is focused on growth arrest to prevent rupture, but invasive open repair or endovascular repair are required in patients at risk. Patient management and risk stratification after diagnosis are critical, especially in the ascending aorta since no endovascular treatments are currently available. According to current guidelines, maximum aortic diameter is the only patient-specific geometrical or fluidodynamic criterion accepted as clinical rupture risk predictor. However, abnormal fluid dynamics at the ascending aorta have been widely reported as potential origin of aortic aneurysms and their understanding could improve the risk assessment of patients. In this study, the fluid dynamics of aortae from healthy controls and patients with Marfan syndrome have been evaluated. To do so, we have compared the performance of computational fluid dynamics and fluid-structure interaction simulations using clinical imaging as patient-specific inputs. We have also designed an in vitro system that could expose human aortic endothelial cells to a fluidodynamic environment that mimics that of aortic simulations. The study has revealed, in Marfan patients, that considering the wall elasticity in simulations is critical to derive precisely fluid dynamic values that hold the potential to stratify such patients. In this sense, fluid-structure interaction simulations have outperformed classic computational fluid dynamics at a moderate computational cost. As a result of this study, a dimensionless parameter, the shear stress ratio, has shown its potential as marker of aneurysm progression in Marfan patients.




Martorell López, Jordi 


IQS SE - Enginyeria Química i Ciència de Materials

Date of defense