This thesis addresses computation fluid dynamics modelling of aortic dissection (AD), in order to generate __in silico__ diagnostic information and assess ‘virtual surgery’ outcomes. The thesis introduces several important advances in the modelling of aortic dissection and lays essential groundwork for further development of this technology. The work thesis represents a unique and major step forward in our understanding of AD using a patient-specific, systematic and coherent simulation approach, and is currently the most advanced work available on AD.

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Alimohammadi, Mona

0009172

Springer Nature Switzerland AG

Springer Theses, Recognizing Outstanding Ph. D. Research, Cham, 2018

Springer theses, Cham, Switzerland, 2018

Springer theses, Cham, 2017

Switzerland, Switzerland

1st ed. 2018, 2018

Jan 21, 2018

6, 20180120

lg2179102

producers:
Acrobat Distiller 10.0.0 (Windows)

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Source title: Aortic Dissection: Simulation Tools for Disease Management and Understanding (Springer Theses)

Supervisors’ Foreword 7
Abstract 9
List of PublicationsJournal Publications1. Alimohammadi, M., Agu, O., Balabani, S. and Dίaz-Zuccarini, V. (2014), ‘Development of a patient-specific tool to analyse aortic dissections: Assessment of mixed patient-specific flow and pressure boundary condition’, Medical Engineering and Physics 36, 275–284.2. Alimohammadi, M., Bhattacharya-Ghosh, B., Seshadri, S., Penrose, J., Agu, O., Balabani, S. and Dίaz-Zuccarini, V. (2014), ‘Evaluation of the hemodynamic effectiveness of aortic dissection treatments via virtual stenting’, International Journal of Artificial Organs 37(10), 753–762.3. Decorato, I., Salsac, A.-V., Legallais, C., Alimohammadi, M., Dίaz-Zuccarini, V. and Kharboutly, Z. (2014), ‘Influence of an arterial stenosis on the hemodynamics within an arteriovenous fistula (AVF): comparison before and after balloon-angioplasty’, Cardiovascular Engineering and Technology 5(3), 233–243.4. Alimohammadi, M., Pichardo-Almarza, C., Di Tomaso, G., Balabani, S., Agu, O. and Dίaz-Zuccarini, V. (2015), ‘Predicting atherosclerotic plaque location in an iliac bifurcation using a hybrid CFD/biomechanical approach’, in IWBBIO 2015, LNCS 9044, 594–606.5. Alimohammadi, M., Sherwood, J.M., Karimpour, M., Agu, O., Balabani, S. and Dίaz-Zuccarini, V ‘Aortic dissection simulation models for clinical support: fluid-structure interaction vs. rigid wall models’. Biomedical Engineering OnLine. 14:34.Book ChaptersDίaz-Zuccarini, V., Alimohammadi, M., Pichardo-Almarza, C., (2015), Reflecting on DISCIPULUS and Remaining Challenges, in ‘The Digital Patient: Advancing Medical Research, Education, and Practice’, Eds. Combs, C.D., Sokolowski, J.A., Banks, C.M., John Wiley and Sons.ConferencesPresentations: M Alimohammadi et al., ‘Coupled 0D and CFD simulation of blood flow through a Stanford type-B aortic dissection’, Congress of the European Society of Biomechanics, Lisbon, 1–4 July, 2012.M Alimohammadi et al., ‘Coupled 0D and CFD simulation of blood flow through a Stanford type-B aortic dissection’, IMA Mathematics of Medical Devices and Surgical Procedures, London, 17–19 September, 2012.Posters: M Alimohammadi et al., ‘Fluid structure interaction simulation of blood flow through a patient-specific Stanford type-B aortic dissection’, World Congress of Biomechanics, Boston, July 6–11, 2014.M Alimohammadi et al., ‘Coupled 0D and CFD simulation of blood flow through a Stanford type-B aortic dissection’, IMA Mathematics of Medical Devices and Surgical Procedures, London, 17–19 September, 2012. Winner of first prize graduate student poster competition.Workshops AttendedeuHeart Project workshop; euHeart is the integrated cardiac care using patient-specific cardiovascular modelling. The workshop focused on the numerical and computational models of aortic coarctation and aortic aneurysm. Sheffield University, 17–18 October, 2011.London Mathematical Society/EPSRC Course on Continuum Mechanics in Biology and Medicine. University College London, 17–22 June, 2012 10
Journal Publications 10
Book Chapters 10
Conferences 10
Workshops Attended 11
Acknowledgements 12
Contents 14
Nomenclature 17
List of Figures 20
List of Tables 26
1 Introduction 27
1.1 Motivation and Background 27
1.1.1 Introduction to the Circulatory System 28
1.1.2 Aortic Dissection 31
1.2 Numerical Modelling of the Cardiovascular System 42
1.2.1 Background 42
1.2.2 Approaches to Modelling Aortic Dissection 43
1.2.3 Objectives of Aortic Dissection Modelling 51
1.3 Objectives of the Present Research 53
1.4 Outline of the Thesis 54
References 55
2 Computational Methods for Patient-Specific Modelling 65
2.1 Computational Fluid Dynamics 65
2.1.1 Governing Equations 66
2.1.2 Numerical Implementation 67
2.2 Building the Fluid Domain 69
2.2.1 Introduction to Clinical Imaging 69
2.2.2 3D Domain Extraction 70
2.2.3 Geometry 74
2.3 Meshing 77
2.4 Dynamic Boundary Conditions 78
2.4.1 Analogue Equations 78
2.4.2 Two-element Windkessel Model 79
2.4.3 Three-element Windkessel Model 80
2.4.4 Four-element Windkessel Models 82
2.4.5 Compound Windkessel Models 83
2.4.6 Parameters for Windkessel Models 83
2.4.7 Comparison of Zero-Pressure and Windkessel Boundary Conditions for Aortic Dissection 85
2.4.8 Comparison of Flow-Split and Windkessel Boundary Conditions for Aortic Dissection 87
2.5 Finite Element Modelling 88
2.5.1 Vessel Wall Reconstruction 89
2.5.2 Material Properties 89
References 91
3 Haemodynamics of a Dissected Aorta 95
3.1 Introduction 95
3.2 Methodology 96
3.2.1 Boundary Conditions and Data Assimilation Method 97
3.3 Results 101
3.3.1 Flow Characteristics 101
3.3.2 Pressure Distribution 105
3.3.3 Wall Shear Stress 107
3.4 Discussion 110
3.4.1 Limitations 111
3.5 Sensitivity of the Windkessel Parameters 113
3.6 Mesh Sensitivity 115
3.7 Effect of Turbulence Modelling 121
3.8 Conclusions 123
References 123
4 Effectiveness of Aortic Dissection Treatments via Virtual Stenting 127
4.1 Introduction 127
4.2 Methodology 129
4.2.1 Boundary Conditions 133
4.3 Results 135
4.3.1 Velocity and Flow Rates 135
4.3.2 Pressure 137
4.3.3 Kinetic Energy 139
4.3.4 Wall Shear Stress 139
4.4 Discussion 143
4.5 Mesh Sensitivity 146
4.6 Conclusion 149
References 150
5 Role of Vessel Wall Motion in Aortic Dissection 153
5.1 Introduction 153
5.2 Methods 155
5.2.1 Geometry 155
5.2.2 Boundary Conditions 156
5.3 Results 158
5.3.1 Wall Displacement 158
5.3.2 Cross-Sectional Area 158
5.3.3 Wall Stress 160
5.3.4 Velocity Distribution 163
5.3.5 Flow Distribution 163
5.3.6 Pressure Distribution 165
5.3.7 Proximal and Distal False Lumen 165
5.3.8 Wall Shear Stress 167
5.4 Mesh Sensitivity and Efficiency 169
5.5 Discussion 173
5.6 Conclusions 176
References 176
6 Conclusions and Future Work 180
6.1 Introduction 180
6.2 Main Contributions 181
6.3 Summary of Main Findings 181
6.4 Significance of this Study 184
6.5 Future Work 184
Appendix A Sample Mesh Images 186
Appendix B Detailed Mesh Sensitivity Analysis for Virtual-Stenting Simulations 189

Front Matter ....Pages i-xxix
Introduction (Mona Alimohammadi)....Pages 1-38
Computational Methods for Patient-Specific Modelling (Mona Alimohammadi)....Pages 39-68
Haemodynamics of a Dissected Aorta (Mona Alimohammadi)....Pages 69-100
Effectiveness of Aortic Dissection Treatments via Virtual Stenting (Mona Alimohammadi)....Pages 101-126
Role of Vessel Wall Motion in Aortic Dissection (Mona Alimohammadi)....Pages 127-153
Conclusions and Future Work (Mona Alimohammadi)....Pages 155-160
Back Matter ....Pages 161-179

2018-02-03