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Wang X, Ghayesh MH, Kotousov A, Zander AC, Dawson JA, Psaltis PJ. Fluid-structure interaction study for biomechanics and risk factors in Stanford type A aortic dissection. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023:e3736. [PMID: 37258411 DOI: 10.1002/cnm.3736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/04/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
Aortic dissection is a life-threatening condition with a rising prevalence in the elderly population, possibly as a consequence of the increasing population life expectancy. Untreated aortic dissection can lead to myocardial infarction, aortic branch malperfusion or occlusion, rupture, aneurysm formation and death. This study aims to assess the potential of a biomechanical model in predicting the risks of a non-dilated thoracic aorta with Stanford type A dissection. To achieve this, a fully coupled fluid-structure interaction model was developed under realistic blood flow conditions. This model of the aorta was developed by considering three-dimensional artery geometry, multiple artery layers, hyperelastic artery wall, in vivo-based physiological time-varying blood velocity profiles, and non-Newtonian blood behaviours. The results demonstrate that in a thoracic aorta with Stanford type A dissection, the wall shear stress (WSS) is significantly low in the ascending aorta and false lumen, leading to potential aortic dilation and thrombus formation. The results also reveal that the WSS is highly related to blood flow patterns. The aortic arch region near the brachiocephalic and left common carotid artery is prone to rupture, showing a good agreement with the clinical reports. The results have been translated into their potential clinical relevance by revealing the role of the stress state, WSS and flow characteristics as the main parameters affecting lesion progression, including rupture and aneurysm. The developed model can be tailored for patient-specific studies and utilised as a predictive tool to estimate aneurysm growth and initiation of wall rupture inside the human thoracic aorta.
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Affiliation(s)
- Xiaochen Wang
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - Mergen H Ghayesh
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - Andrei Kotousov
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - Anthony C Zander
- School of Mechanical Engineering, University of Adelaide, Adelaide, Australia
| | - Joseph A Dawson
- Department of Vascular & Endovascular Surgery, Royal Adelaide Hospital, Adelaide, Australia
- Trauma Surgery Unit, Royal Adelaide Hospital, Adelaide, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Peter J Psaltis
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Vascular Research Centre, Lifelong Health Theme, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia
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Oropeza BP, Adams JR, Furth ME, Chessa J, Boland T. Bioprinting of Decellularized Porcine Cardiac Tissue for Large-Scale Aortic Models. Front Bioeng Biotechnol 2022; 10:855186. [PMID: 35360395 PMCID: PMC8960451 DOI: 10.3389/fbioe.2022.855186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Bioprinting is an emerging technique used to layer extrudable materials and cells into simple constructs to engineer tissue or arrive at in vitro organ models. Although many examples of bioprinted tissues exist, many lack the biochemical complexity found in the native extracellular matrix. Therefore, the resulting tissues may be less competent than native tissues—this can be especially problematic for tissues that need strong mechanical properties, such as cardiac or those found in the great vessels. Decellularization of native tissues combined with processing for bioprinting may improve the cellular environment for proliferation, biochemical signaling, and improved mechanical characteristics for better outcomes. Whole porcine hearts were decellularized using a series of detergents, followed by lyophilization and mechanical grinding in order to produce a fine powder. Temperature-controlled enzymatic digestion was done to allow for the resuspension of the decellularized extracellular matrix into a pre-gel solution. Using a commercial extrusion bioprinter with a temperature-controlled printhead, a 1:1 scale model of a human ascending aorta and dog bone shaped structures were printed into a reservoir of alginate and xanthium gum then allowed to crosslink at 37C. The bioengineered aortic construct was monitored for cell adhesion, survival, and proliferation through fluorescent microscopy. The dog bone structure was subjected to tensile mechanical testing in order to determine structural and mechanical patterns for comparison to native tissue structures. The stability of the engineered structure was maintained throughout the printing process, allowing for a final structure that upheld the dimensions of the original Computer-Aided Design model. The decellularized ECM (Ē = 920 kPa) exhibited almost three times greater elasticity than the porcine cardiac tissue (Ē = 330 kPa). Similarly, the porcine cardiac tissue displayed two times the deformation than that of the printed decellularized ECM. Cell proliferation and attachment were observed during the in vitro cell survivability assessment of human aortic smooth muscle cells within the extracellular matrix, along with no morphological abnormalities to the cell structure. These observations allow us to report the ability to bioprint mechanically stable, cell-laden structures that serve as a bridge in the current knowledge gap, which could lead to future work involving complex, large-scale tissue models.
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Affiliation(s)
- Beu P. Oropeza
- Biomedical Device, Delivery and Diagnostic Laboratory, Metallurgical, Materials and Biomedical Engineering Department, The University of Texas at El Paso, El Paso, TX, United States
| | - Jason R. Adams
- Aerospace and Mechanical Engineering, The University of Texas at El Paso, El Paso, TX, United States
| | - Michael E. Furth
- Biomedical Device, Delivery and Diagnostic Laboratory, Metallurgical, Materials and Biomedical Engineering Department, The University of Texas at El Paso, El Paso, TX, United States
| | - Jack Chessa
- Aerospace and Mechanical Engineering, The University of Texas at El Paso, El Paso, TX, United States
| | - Thomas Boland
- Biomedical Device, Delivery and Diagnostic Laboratory, Metallurgical, Materials and Biomedical Engineering Department, The University of Texas at El Paso, El Paso, TX, United States
- *Correspondence: Thomas Boland,
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Piskin S, Patnaik SS, Han D, Bordones AD, Murali S, Finol EA. A canonical correlation analysis of the relationship between clinical attributes and patient-specific hemodynamic indices in adult pulmonary hypertension. Med Eng Phys 2020; 77:1-9. [PMID: 32007361 DOI: 10.1016/j.medengphy.2020.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/19/2019] [Accepted: 01/06/2020] [Indexed: 11/19/2022]
Abstract
Pulmonary hypertension (PH) is a progressive disease affecting approximately 10-52 cases per million, with a higher incidence in women, and with a high mortality associated with right ventricle (RV) failure. In this work, we explore the relationship between hemodynamic indices, calculated from in silico models of the pulmonary circulation, and clinical attributes of RV workload and pathological traits. Thirty-four patient-specific pulmonary arterial tree geometries were reconstructed from computed tomography angiography images and used for volume meshing for subsequent computational fluid dynamics (CFD) simulations. Data obtained from the CFD simulations were post-processed resulting in hemodynamic indices representative of the blood flow dynamics. A retrospective review of medical records was performed to collect the clinical variables measured or calculated from standard hospital examinations. Statistical analyses and canonical correlation analysis (CCA) were performed for the clinical variables and hemodynamic indices. Systolic pulmonary artery pressure (sPAP), diastolic pulmonary artery pressure (dPAP), cardiac output (CO), and stroke volume (SV) were moderately correlated with spatially averaged wall shear stress (0.60 ≤ R2 ≤ 0.66; p < 0.05). Similarly, the CCA revealed a linear and strong relationship (ρ = 0.87; p << 0.001) between 5 clinical variables and 2 hemodynamic indices. To this end, in silico models of PH blood flow dynamics have a high potential for predicting the relevant clinical attributes of PH if analyzed in a group-wise manner using CCA.
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Affiliation(s)
- Senol Piskin
- Department of Mechanical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA; Department of Mechanical Engineering, Istinye University, Zeytinburnu, Istanbul 34010, Turkey
| | - Sourav S Patnaik
- Department of Mechanical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
| | - David Han
- Department of Management Science and Statistics, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
| | - Alifer D Bordones
- Department of Biomedical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
| | - Srinivas Murali
- Department of Radiology and Department of Cardiology, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, USA.
| | - Ender A Finol
- Department of Mechanical Engineering, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
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Theoretical Study on Pressure Damage Based on Clinical Purpura during the Laser Irradiation of Port Wine Stains with Real Complex Vessels. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9245478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Port wine stains (PWSs) are congenital dermal vascular lesions composed of a hyperdilated vasculature. Purpura represented by local hemorrhage from water vaporization in blood during laser therapy of PWS is typically considered a clinical feedback, but with a low cure rate. In this study, light propagation and heat deposition in skin and PWSs is simulated by a tetrahedron-based Monte Carlo method fitted to curved bio-tissues. A curvature-corrected pressure damage model was established to accurately evaluate the relationship between purpura-bleeding area (rate) and laser therapy strategy for real complex vessels. Results showed that the standard deviation of Gaussian curvature of the vessel wall has negative relation with the fluence threshold of vessel rupture, but has positive relation with the effective laser fluence of vessel damage. This finding indicated the probable reason for the poor treatment of PWS, that is, considering purpura formation as a treatment end point (TEP) only leads to partial removal of vascular lesions. Instead, appropriate purpura area ratio with marked effects or rehabilitation should be adopted as TEP. The quantitative correlation between the fluence of a pulsed dye laser and the characteristics of vascular lesions can provide personalized and precise guidance for clinical treatments.
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Lundh T, Suh GY, DiGiacomo P, Cheng C. A Lagrangian cylindrical coordinate system for characterizing dynamic surface geometry of tubular anatomic structures. Med Biol Eng Comput 2018; 56:1659-1668. [PMID: 29500737 PMCID: PMC6096747 DOI: 10.1007/s11517-018-1801-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 02/03/2018] [Indexed: 11/29/2022]
Abstract
Vascular morphology characterization is useful for disease diagnosis, risk stratification, treatment planning, and prediction of treatment durability. To quantify the dynamic surface geometry of tubular-shaped anatomic structures, we propose a simple, rigorous Lagrangian cylindrical coordinate system to monitor well-defined surface points. Specifically, the proposed system enables quantification of surface curvature and cross-sectional eccentricity. Using idealized software phantom examples, we validate the method's ability to accurately quantify longitudinal and circumferential surface curvature, as well as eccentricity and orientation of eccentricity. We then apply the method to several medical imaging data sets of human vascular structures to exemplify the utility of this coordinate system for analyzing morphology and dynamic geometric changes in blood vessels throughout the body. Graphical abstract Pointwise longitudinal curvature of a thoracic aortic endograft surface for systole and diastole, with their absolute difference.
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Affiliation(s)
- Torbjörn Lundh
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA. .,Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, 412 96, Gothenburg, Sweden.
| | - Ga-Young Suh
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA
| | - Phillip DiGiacomo
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Christopher Cheng
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA
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Jalalahmadi G, Helguera M, Mix DS, Linte CA. Toward modeling the effects of regional material properties on the wall stress distribution of abdominal aortic aneurysms. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10578:105780I. [PMID: 31213733 PMCID: PMC6581509 DOI: 10.1117/12.2294558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The overall geometry and different biomechanical parameters of an abdominal aortic aneurysm (AAA), contribute to its severity and risk of rupture, therefore they could be used to track its progression. Previous and ongoing research efforts have resorted to using uniform material properties to model the behavior of AAA. However, it has been recently illustrated that different regions of the AAA wall exhibit different behavior due to the effect of the biological activities in the metalloproteinase matrix that makes up the wall at the aneurysm site. In this work, we introduce a non-invasive patient-specific regional material property model to help us better understand and investigate the AAA wall stress distribution, peak wall stress (PWS) severity, and potential rupture risk. Our results indicate that the PWS and the overall wall stress distribution predicted using the proposed regional material property model, are higher than those predicted using the traditional homogeneous, hyper-elastic model (p <1.43E-07). Our results also show that to investigate AAA, the overall geometry, presence of intra-luminal thrombus (ILT), and loading condition in a patient specific manner may be critical for capturing the biomechanical complexity of AAAs.
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Affiliation(s)
- Golnaz Jalalahmadi
- Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, USA
| | - María Helguera
- Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, USA
- Instituto Tecnológico José Mario Molina Pasquel y Henríquez - Unidad Lagos de Moreno, Jalisco, México
| | - Doran S Mix
- Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, USA
- Department of Surgery, Division of Vascular Surgery, University of Rochester Medical Center, Rochester, USA
| | - Cristian A Linte
- Chester F. Carlson Center for Imaging Science, Rochester Institute of Technology, Rochester, USA
- Biomedical Engineering Department, Rochester Institute of Technology, Rochester, USA
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Ruiz de Galarreta S, Antón R, Cazón A, Finol EA. A methodology for developing anisotropic AAA phantoms via additive manufacturing. J Biomech 2017; 57:161-166. [DOI: 10.1016/j.jbiomech.2017.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/05/2017] [Accepted: 04/09/2017] [Indexed: 01/20/2023]
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