Numerical modeling and simulations of

type B aortic dissection

Igor Saveljić1,2, Lazar Velicki3, Dalibor Nikolić2, and Nenad Filipović1,2

1Faculty of Engineering University of Kragujevac, Sestre Janjic 6, 34000 Kragujevac, Serbia, e-mail:
isaveljic@kg.ac.rs
2Research and Development Center for Bioengineering, University of Kragujevac, Prvoslava Stojanovica 6,

34000 Kragujevac, Serbia

3Faculty of Medicine Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
 The aorta is the main and largest blood vessel in man, and constantly exposed to
high pressure and shear forces. An aortic dissection is one of the most life-
threatening diseases of the human vascular system.

 Aortic dissection occurs when a tear in the inner wall of the aorta causes blood to
flow between the layers of the wall of the aorta, forcing the layers apart.

 The mortality rate is 1% for every hour of occurrence of acute aortic dissection.
 Hypertension - one of the risk factors for aortic dissection, because high pressure
in blood vessel causes damage to the aortic wall (especially the endothelium).

 Atherosclerosis (the aging vessel) - causes cracks in the endothelium (inner layer
of the wall).

 Marfan syndrome - a congenital disorder in the synthesis of elastin fibers of blood

vessels (aorta), which leads to weakness of their walls.

 Iatrogenic factors - mechanical injury of the aortic wall during coronary artery
catheterization, balloon pump placement..

 Mechanical injury due to eg. traffic accidents, falls from great heights etc.
DeBakey

 Type I – Originates in ascending aorta, propagates at least to the aortic arch and
often beyond it distally.

 Type II – Originates in ascending aorta and is confined to the ascending aorta.

 Type III – Originates in descending aorta, rarely extends proximally but will extend
distally.

Stanford

 A – Involves the ascending aorta and/or

aortic arch, and possibly the descending aorta.

 B – Involves the descending aorta or the arch

without involvement of the ascending aorta.
 The difference in blood pressure between the right and left hand,

 The sudden appearance of sharp and severe pain in the chest,

 Loss of consciousness,

 Heart attack,

 The pericardial tamponade,

 Renal insufficiency.
 Two models of dissected aorta geometry was imaged with CT, and segmented
using Mimics v10 visualization software.

 FEMAP is used to creating 3D mesh. Tetrahedral elements was used the final
element.

 PAKF software was used for the numerical solution of fluid flow problems.

 The flow was assumed to be laminar, Newtonian, and incompressible. The

continuity and Navier–Stokes equations are as follows:
 Patient #01 is a 61 year old male, a non-smoker, who was diagnosed with
hypertension and acute aortic dissection (type B – DeBakey classification).

 Patient #02 is a man aged 63 years, a non-smoker, who was diagnosed with
hypertension and acute aortic dissection (also type B). There is a re-entry to a
length of 84.56 mm from the aortic bifurcation in the iliac arteries. Cross-sectional
area of the return entry is 0.87 cm2.

Patient No. Age Entry tear Distance Volume of Volume of

[years] [cm2] from aortic true lumen false lumen
arch [mm] [cm3] [cm3]
#01 61 0.92 29.74 237.32 198.84

#02 63 0.67 56.92 410.99 799.61

 Results for patient #01

 Flow rates were recorded through the aortic branches are: 14.90 cm3/s through the
brachiocephalic artery, 12.60 cm3/s through the left common carotid and 11.41
cm3/s through the left subclavian artery. False lumen takes 26.85% of the total
flow.
 Results for patient #02

 Flows through the branches of the aortic arch are: 13.86 cm3/s through the
brachiocephalic artery, 6.75 cm3/s through the left common carotid and 8.52 cm3/s
through the left subclavian artery. Through this the false lumen of the patient, is
achieved by 15.40% of the total flow.
Studying the type B (DeBakey classification) of aorta dissection, we
noticed a link between the location and size of the entry tear.
 Cardiovascular disease is the leading cause of death in all developed
countries.

 Aortic dissection is one of the most serious disease that starts

splitting intimal layer of the aortic wall.

 The aim of the simulation was numerically determining the

relationship between true and false lumen of acute aortic dissection.

 It has been shown that with increasing distance of the entry tear from
the top of the aortic arch growing volume of false lumen.
Here are a few tips to reduce your risk of an aortic dissection:

 Control blood pressure,

 Don't smoke,

 Maintain an ideal weight (follow a low-salt diet with plenty of fruits,

vegetables and whole grains and exercise regularly),

 Wear a seat belt (this reduces the risk of traumatic injury to your
chest area),

 Work with your doctor (check a family history of aortic dissection and
tell your doctor if you have a genetic predisposition for the
development of this disease).
Thank for your attention!