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...

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Autores principales:	Salvatore Cutugno, Valentina Agnese, Giovanni Gentile, Giuseppe M. Raffa, Andrew D. Wisneski, Julius M. Guccione, Michele Pilato, Salvatore Pasta
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	ascending aortic aneurysm cardiac mechanics finite element analysis living heart human model Technology T Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/296c278d7b5840da9b434272ed00976b
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spelling	oai:doaj.org-article:296c278d7b5840da9b434272ed00976b2021-11-25T16:46:35ZPatient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model10.3390/bioengineering81101752306-5354https://doaj.org/article/296c278d7b5840da9b434272ed00976b2021-11-01T00:00:00Zhttps://www.mdpi.com/2306-5354/8/11/175https://doaj.org/toc/2306-5354In 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.Salvatore CutugnoValentina AgneseGiovanni GentileGiuseppe M. RaffaAndrew D. WisneskiJulius M. GuccioneMichele PilatoSalvatore PastaMDPI AGarticleascending aortic aneurysmcardiac mechanicsfinite element analysisliving heart human modelTechnologyTBiology (General)QH301-705.5ENBioengineering, Vol 8, Iss 175, p 175 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ascending aortic aneurysm cardiac mechanics finite element analysis living heart human model Technology T Biology (General) QH301-705.5
spellingShingle	ascending aortic aneurysm cardiac mechanics finite element analysis living heart human model Technology T Biology (General) QH301-705.5 Salvatore Cutugno Valentina Agnese Giovanni Gentile Giuseppe M. Raffa Andrew D. Wisneski Julius M. Guccione Michele Pilato Salvatore Pasta Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model
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	article
author	Salvatore Cutugno Valentina Agnese Giovanni Gentile Giuseppe M. Raffa Andrew D. Wisneski Julius M. Guccione Michele Pilato Salvatore Pasta
author_facet	Salvatore Cutugno Valentina Agnese Giovanni Gentile Giuseppe M. Raffa Andrew D. Wisneski Julius M. Guccione Michele Pilato Salvatore Pasta
author_sort	Salvatore Cutugno
title	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_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_sort	patient-specific analysis of ascending thoracic aortic aneurysm with the living heart human model
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/296c278d7b5840da9b434272ed00976b
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Patient-Specific Analysis of Ascending Thoracic Aortic Aneurysm with the Living Heart Human Model

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