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Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model
In ascending thoracic aortic aneurysms (ATAAs), aneurysm kinematics are driven by ventricular traction occurring every heartbeat, increasing the stress level of dilated aortic wall. Aortic elongation due to heart motion and aortic length are emerging as potential indicators of adverse events in ATAA...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615119/ https://www.ncbi.nlm.nih.gov/pubmed/34821741 http://dx.doi.org/10.3390/bioengineering8110175 |
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author | Cutugno, Salvatore Agnese, Valentina Gentile, Giovanni Raffa, Giuseppe M. Wisneski, Andrew D. Guccione, Julius M. Pilato, Michele Pasta, Salvatore |
author_facet | Cutugno, Salvatore Agnese, Valentina Gentile, Giovanni Raffa, Giuseppe M. Wisneski, Andrew D. Guccione, Julius M. Pilato, Michele Pasta, Salvatore |
author_sort | Cutugno, Salvatore |
collection | PubMed |
description | In ascending thoracic aortic aneurysms (ATAAs), aneurysm kinematics are driven by ventricular traction occurring every heartbeat, increasing the stress level of dilated aortic wall. Aortic elongation due to heart motion and aortic length are emerging as potential indicators of adverse events in ATAAs; however, simulation of ATAA that takes into account the cardiac mechanics is technically challenging. The objective of this study was to adapt the realistic Living Heart Human Model (LHHM) to the anatomy and physiology of a patient with ATAA to assess the role of cardiac motion on aortic wall stress distribution. Patient-specific segmentation and material parameter estimation were done using preoperative computed tomography angiography (CTA) and ex vivo biaxial testing of the harvested tissue collected during surgery. The lumped-parameter model of systemic circulation implemented in the LHHM was refined using clinical and echocardiographic data. The results showed that the longitudinal stress was highest in the major curvature of the aneurysm, with specific aortic quadrants having stress levels change from tensile to compressive in a transmural direction. This study revealed the key role of heart motion that stretches the aortic root and increases ATAA wall tension. The ATAA LHHM is a realistic cardiovascular platform where patient-specific information can be easily integrated to assess the aneurysm biomechanics and potentially support the clinical management of patients with ATAAs. |
format | Online Article Text |
id | pubmed-8615119 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86151192021-11-26 Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model Cutugno, Salvatore Agnese, Valentina Gentile, Giovanni Raffa, Giuseppe M. Wisneski, Andrew D. Guccione, Julius M. Pilato, Michele Pasta, Salvatore Bioengineering (Basel) Article In ascending thoracic aortic aneurysms (ATAAs), aneurysm kinematics are driven by ventricular traction occurring every heartbeat, increasing the stress level of dilated aortic wall. Aortic elongation due to heart motion and aortic length are emerging as potential indicators of adverse events in ATAAs; however, simulation of ATAA that takes into account the cardiac mechanics is technically challenging. The objective of this study was to adapt the realistic Living Heart Human Model (LHHM) to the anatomy and physiology of a patient with ATAA to assess the role of cardiac motion on aortic wall stress distribution. Patient-specific segmentation and material parameter estimation were done using preoperative computed tomography angiography (CTA) and ex vivo biaxial testing of the harvested tissue collected during surgery. The lumped-parameter model of systemic circulation implemented in the LHHM was refined using clinical and echocardiographic data. The results showed that the longitudinal stress was highest in the major curvature of the aneurysm, with specific aortic quadrants having stress levels change from tensile to compressive in a transmural direction. This study revealed the key role of heart motion that stretches the aortic root and increases ATAA wall tension. The ATAA LHHM is a realistic cardiovascular platform where patient-specific information can be easily integrated to assess the aneurysm biomechanics and potentially support the clinical management of patients with ATAAs. MDPI 2021-11-04 /pmc/articles/PMC8615119/ /pubmed/34821741 http://dx.doi.org/10.3390/bioengineering8110175 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cutugno, Salvatore Agnese, Valentina Gentile, Giovanni Raffa, Giuseppe M. Wisneski, Andrew D. Guccione, Julius M. Pilato, Michele Pasta, Salvatore Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model |
title | Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model |
title_full | Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model |
title_fullStr | Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model |
title_full_unstemmed | Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model |
title_short | Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model |
title_sort | patient-specific analysis of ascending thoracic aortic aneurysm with the living heart human model |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615119/ https://www.ncbi.nlm.nih.gov/pubmed/34821741 http://dx.doi.org/10.3390/bioengineering8110175 |
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