Tese e Dissertação

Tese: Numerical prediction of hemodynamic patterns during a cardiac cycle for one healthy and 30 aneurysmatic aortas

This study presents the validation of a physical/numerical model designed to predict the ascending aorta flow in a healthy patient, aiming to extend its application to analyze other patients, specifically, with ascending aortic aneurysm (AAoA). Applying the patient-specific model (PSM) concept, the results provided by the Four-dimensional Flow Magnetic Resonance Imaging (4D Flow MRI) technique were used in the simulation employing the Computational Fluid Dynamics (CFD) approach, with a turbulence model capable of predicting laminar/turbulent regime transitions during the cardiac cycle. Boundary condition based on measured flow rate was imposed at the aorta´s inlet. At the outlets, the physiological percentages of inlet flow rate corresponding to each output were considered, as well as the three-element Windkessel model to establish a more accurate approximation of the pressure-flow relationship. The favorable results obtained on pressure, flow rate and shear stress profiles at various positions along the aorta and throughout the cardiac cycle, validated the potential application of PSM to other patients, in particular patients with AAoA. AAoA is a silent disease with high mortality, and factors associated with a worse prognosis are not yet fully known. Aiming to relate flow dynamics characteristics with the disease, personalized anatomic models were obtained from angiotomography scans of 30 patients in two different years (with intervals of one to three years between them). Based on the volume difference of the ascending aorta from one year to another, two groups were defined: one with aneurysm growth and another without growth. The flow field during the cardiac cycle and the geometry corresponding to each group were compared to find patterns that may indicate the aneurysm growth from the first exam. Although there was no clear trend between the two patient groups, higher time-averaged pressure (TAP) values were observed in patients with aneurysm growth, as well as longer time periods during the cycle with the aorta subjected to high values of shear stress. The present study explored the remodeling process of patients with aneurysm and how the geometry and flow pattern can impact its growth, contributing to a better understanding of aortic pathophysiology.

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