Mechanical behaviour and rupture of normal and pathological human ascending aortic wall

The mechanical properties of aortic wall, both healthy and pathological, are needed in order to develop and improve diagnostic and interventional criteria, and for the development of mechanical models to assess arterial integrity. This study focuses on the mechanical behaviour and rupture conditions of the human ascending aorta and its relationship with age and pathologies. Fresh ascending aortic specimens harvested from 23 healthy donors, 12 patients with bicuspid aortic valve (BAV) and 14 with aneurysm were tensile-tested in vitro under physiological conditions. Tensile strength, stretch at failure and elbow stress were measured. The obtained results showed that age causes a major reduction in the mechanical parameters of healthy ascending aortic tissue, and that no significant differences are found between the mechanical strength of aneurysmal or BAV aortic specimens and the corresponding age-matched control group. The physiological level of the stress in the circumferential direction was also computed to assess the physiological operation range of healthy and diseased ascending aortas. The mean physiological wall stress acting on pathologic aortas was found to be far from rupture, with factors of safety (defined as the ratio of tensile strength to the mean wall stress) larger than six. In contrast, the physiological operation of pathologic vessels lays in the stiff part of the response curve, losing part of its function of damping the pressure waves from the heart.

Relationship between fibre orientation and tensile strength of natural collagen membranes for heart valve leaflets

Heart valve prostheses are used to replace native heart valves which that are damaged because of congenital diseases or due to ageing. Biological prostheses made of bovine pericardium are similar to native valves and do not require any anticoagulation treatment, but are less durable than mechanical prostheses and usually fail by tearing. Researches are oriented in improving the resistance and durability of biological heart valve prostheses in order to increase their life expectancy. To understand the mechanical behaviour of bovine pericardium and relate it to its microstructure (mainly collagen fibres concentration and orientation) uniaxial tensile tests have been performed on a model material made of collagen fibres. Small Angle Light Scattering (SALS) has been also used to characterize the microstructure without damaging the material. Results with the model material allowed us to obtain the orientation of the fibres, relating the microstructure to mechanical performance

Estudio mecánico sobre la resistencia de la pared de la aorta humana como predictor de riesgo de rotura de aneurisma

Definir el riesgo de rotura de un aneurisma, se considera un factor básico para elegir el momento adecuado de la intervención quirúrgica. Uno de los parámetros clásico utilizados es el diámetro del aneurisma (Ley de la Place). Sin embargo, otro factor mecánico como es el cociente entre la tensión máxima que soporta la pared (depende del diámetro de la aorta y de la morfología) y de la resistencia del material (pared de la aorta) es un elemento poco conocido. La razón estriba en comparar aortas “sanas” con “patológicas”. Este estudio lo hemos realizado en colaboración con el Departamento de Ciencias de Materiales de la Universidad Politécnica de Madrid

Automatic generation of real-time deformable parametric model of the aorta for a VR-based catheterism guidance system

The purpose of this work is twofold: first, to develop a process to automatically create parametric models of the aorta that can adapt to any possible intraoperative deformation of the vessel. Second, it intends to provide the tools needed to perform this deformation in real time, by means of a non-rigid registration method. This dynamically deformable model will later be used in a VR-based surgery guidance system for aortic catheterism procedures, showing the vessel changes in real time.

Caracterización mecánica de injertos de aorta ascendente de Dacron®

El presente trabajo fin de máster tiene como objetivo caracterizar los injertos de Dacron®, que se utilizan para reparar patologías de la aorta ascendente, para comparar el comportamiento mecánico con el que presenta la aorta ascendente. Se han realizado ensayos uniaxiales de tracción, de relajación y con una historia de cargas variable, tanto en probetas extraidas en la dirección circunferencial al tubo del injerto como en dirección longitudinal. Posteriormente, se han obtenido los parámetros necesarios para que los datos se ajusten a un modelo mecánico basado en el modelo de Maxwell generalizado. Por último, los datos obtenidos de los ensayos y los parámetros del modelo se han comparado con los ensayos y modelos de la aorta, obtenidos de la literatura.

Pulsatile blood flow interaction with arterial walls of aorta : autoregulation and impedance pressure boundary condition and its biomedical applications

Para las decisiones urgentes sobre intervenciones quirúrgicas en el sistema cardiovascular se necesitan simulaciones computacionales con resultados fiables y que consuman un tiempo de cálculo razonable. Durante años los investigadores han trabajado en diversos métodos numéricos de cálculo que resulten atractivos para los cirujanos. Estos métodos, precisos pero costosos desde el punto de vista del coste computacional, crean un desajuste entre la oferta de los ingenieros que realizan las simulaciones y los médicos que operan en el quirófano. Por otra parte, los métodos de cálculo más simplificados reducen el tiempo de cálculo pero pueden proporcionar resultados no realistas. El objetivo de esta tesis es combinar los conceptos de autorregulación e impedancia del sistema circulatorio, la interacción flujo sanguíneo-pared arterial y modelos geométricos idealizados tridimensionales de las arterias pero sin pérdida de realismo, con objeto de proponer una metodología de simulación que proporcione resultados correctos y completos, con tiempos de cálculo moderados. En las simulaciones numéricas, las condiciones de contorno basadas en historias de presión presentan inconvenientes por ser difícil conocerlas con detalle, y porque los resultados son muy sensibles ante pequeñas variaciones de dichas historias. La metodología propuesta se basa en los conceptos de autorregulación, para imponer la demanda de flujo aguas abajo del modelo en el ciclo cardiaco, y la impedancia, para representar el efecto que ejerce el flujo en el resto del sistema circulatorio sobre las arterias modeladas. De este modo las historias de presión en el contorno son resultados del cálculo, que se obtienen de manera iterativa. El método propuesto se aplica en una geometría idealizada del arco aórtico sin patologías y en otra geometría correspondiente a una disección Stanford de tipo A, considerando la interacción del flujo pulsátil con las paredes arteriales. El efecto de los tejidos circundantes también se incorpora en los modelos. También se hacen aplicaciones considerando la interacción en una geometría especifica de un paciente anciano que proviene de una tomografía computarizada. Finalmente se analiza una disección Stanford tipo B con tres modelos que incluyen la fenestración del saco. Clinicians demand fast and reliable numerical results of cardiovascular biomechanic simulations for their urgent pre-surgery decissions. Researchers during many years have work on different numerical methods in order to attract the clinicians' confidence to their colorful contours. Though precise but expensive and time-consuming methodologies create a gap between numerical biomechanics and hospital personnel. On the other hand, simulation simplifications with the aim of reduction in computational time may cause in production of unrealistic outcomes. The main objective of the current investigation is to combine ideas such as autoregulation, impedance, fluid-solid interaction and idealized geometries in order to propose a computationally cheap methodology without excessive or unrealistic simplifications. The pressure boundary conditions are critical and polemic in numerical simulations of cardiovascular system, in which a specific arterial site is of interest and the rest of the netwrok is neglected but represented by a boundary condition. The proposed methodology is a pressure boundary condition which takes advantage of numerical simplicity of application of an imposed pressure boundary condition on outlets, while it includes more sophisticated concepts such as autoregulation and impedance to gain more realistic results. Incorporation of autoregulation and impedance converts the pressure boundary conditions to an active and dynamic boundary conditions, receiving feedback from the results during the numerical calculations and comparing them with the physiological requirements. On the other hand, the impedance boundary condition defines the shapes of the pressure history curves applied at outlets. The applications of the proposed method are seen on idealized geometry of the healthy arotic arch as well as idealized Stanford type A dissection, considering the interaction of the arterial walls with the pulsatile blood flow. The effect of surrounding tissues is incorporated and studied in the models. The simulations continue with FSI analysis of a patient-specific CT scanned geometry of an old individual. Finally, inspiring of the statistic results of mortality rates in Stanford type B dissection, three models of fenestrated dissection sac is studied and discussed. Applying the developed boundary condition, an alternative hypothesis is proposed by the author with respect to the decrease in mortality rates in patients with fenestrations.