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1.
Bioprocess Biosyst Eng ; 46(5): 681-692, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36806976

RESUMEN

Bioreactors can perform biochemical conversions mediated by biocatalysts, such as enzymes, animal cells, plants, and microorganisms. Among several existing models, airlift bioreactors are devices with the low shear environment and good mass transfer with low energy consumption, employed in several biochemical processes. The fluid flow is enabled through air injection by the sparger located at the bioreactor base. Despite its simple geometry compared with the conventional bioreactors, airlift performance can be optimized via geometrical modifications. Therefore, the objective of this work was to evaluate the effects of the addition of helical flow promoters, positioned in the riser and/or downcomer regions of an airlift of concentric tubes measuring the volumetric oxygen coefficient (kLa) and gas holdup. The results obtained by varying the gas flow rate from 1.0 to 4.0 vvm allowed the system evaluation of oxygen transfer and gas holdup. The inclusion of helical flow promoters increased the kLa, reaching up to 23% in oxygen transfer compared to tests without helicoids and up to 14% increase in the gas holdup. The inclusion of helical flow promotors was beneficial for all gas flow rates. Thus, including these flow promoters is an effective strategy to increase the oxygen transfer rate for bioprocess optimization.


Asunto(s)
Reactores Biológicos , Oxígeno , Oxígeno/química
2.
Eur Radiol ; 32(12): 8597-8607, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35612663

RESUMEN

OBJECTIVES: 4D flow MRI enables quantitative assessment of helical flow. We sought to generate normal values and elucidate changes of helical flow (duration, volume, length, velocities and rotational direction) and flow jet (displacement, flow angle) as well as wall shear stress (WSS). METHODS: We assessed the temporal helical existence (THEX), maximum helical volume (HVmax), accumulated helical volume (HVacc), accumulated helical volume length (HVLacc), maximum forward velocity (maxVfor), maximum circumferential velocity (maxVcirc), rotational direction (RD) and maximum wall shear stress (WSS) as reported elsewhere using the software tool Bloodline in 86 healthy volunteers (46 females, mean age 41 ± 13 years). RESULTS: WSS decreased by 42.1% and maxVfor by 55.7% across age. There was no link between age and gender regarding the other parameters. CONCLUSION: This study provides age-dependent normal values regarding WSS and maxVfor and age- and gender-independent normal values regarding THEX, HVmax, HVacc, HVLacc, RD and maxVcirc. KEY POINTS: • 4D flow provides numerous new parameters; therefore, normal values are mandatory. • Wall shear stress decreases over age. • Maximum helical forward velocity decreases over age.


Asunto(s)
Aorta , Hemodinámica , Femenino , Humanos , Adulto , Persona de Mediana Edad , Velocidad del Flujo Sanguíneo , Valores de Referencia , Voluntarios Sanos , Estrés Mecánico
3.
J Cardiovasc Magn Reson ; 21(1): 63, 2019 10 14.
Artículo en Inglés | MEDLINE | ID: mdl-31607265

RESUMEN

BACKGROUND: Diseases of the descending aorta have emerged as a clinical issue in Marfan syndrome following improvements in proximal aorta surgical treatment and the consequent increase in life expectancy. Although a role for hemodynamic alterations in the etiology of descending aorta disease in Marfan patients has been suggested, whether flow characteristics may be useful as early markers remains to be determined. METHODS: Seventy-five Marfan patients and 48 healthy subjects were prospectively enrolled. In- and through-plane vortexes were computed by 4D flow cardiovascular magnetic resonance (CMR) in the thoracic aorta through the quantification of in-plane rotational flow and systolic flow reversal ratio, respectively. Regional pulse wave velocity and axial and circumferential wall shear stress maps were also computed. RESULTS: In-plane rotational flow and circumferential wall shear stress were reduced in Marfan patients in the distal ascending aorta and in proximal descending aorta, even in the 20 patients free of aortic dilation. Multivariate analysis showed reduced in-plane rotational flow to be independently related to descending aorta pulse wave velocity. Conversely, systolic flow reversal ratio and axial wall shear stress were altered in unselected Marfan patients but not in the subgroup without dilation. In multivariate regression analysis proximal descending aorta axial (p = 0.014) and circumferential (p = 0.034) wall shear stress were independently related to local diameter. CONCLUSIONS: Reduced rotational flow is present in the aorta of Marfan patients even in the absence of dilation, is related to aortic stiffness and drives abnormal circumferential wall shear stress. Axial and circumferential wall shear stress are independently related to proximal descending aorta dilation beyond clinical factors. In-plane rotational flow and circumferential wall shear stress may be considered as an early marker of descending aorta dilation in Marfan patients.


Asunto(s)
Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Hemodinámica , Angiografía por Resonancia Magnética , Imagen por Resonancia Cinemagnética , Síndrome de Marfan/complicaciones , Imagen de Perfusión/métodos , Adulto , Aorta Torácica/fisiopatología , Aneurisma de la Aorta Torácica/etiología , Aneurisma de la Aorta Torácica/fisiopatología , Velocidad del Flujo Sanguíneo , Estudios de Casos y Controles , Dilatación Patológica , Femenino , Humanos , Masculino , Síndrome de Marfan/diagnóstico , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Flujo Sanguíneo Regional , Estrés Mecánico , Rigidez Vascular , Adulto Joven
4.
Biomed Eng Online ; 17(1): 85, 2018 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-29921281

RESUMEN

BACKGROUND AND AIMS: The crossed limbs stent graft technique is regularly employed to treat abdominal aortic aneurysm patients with unfavorable aneurysm necks or widely splayed common iliac arteries. This article numerically evaluates the hemodynamic performance of the crossed limbs strategy by analyzing numerical simulations and conducting experiments using two series of idealized bifurcated stent grafts with different cross angles and cross positions. RESULTS: Results demonstrated that the absolute helicity at outlets decreased with increased cross angles and increased with decreased cross positions. The time-averaged wall shear stress remained approximately unchanged, whereas the oscillating shear index and relative resident time decreased slightly when the cross angle increased and cross position decreased in iliac grafts. Additionally, both numerical and in vitro experimental results indicate the displacement force acting on the stent graft gradually increased as cross angles increased and cross positions decreased. Results further indicated that strip areas with a high oscillating shear index and high relative resident time, which may be vulnerable to thrombosis formation, exist along the outer surface of the iliac artery grafts. CONCLUSION: Given this information, the optimal crossed limbs configuration may contain a small cross angle and low cross position; however, low cross positions may increase the risk of migration.


Asunto(s)
Simulación por Computador , Hemodinámica , Stents , Aneurisma de la Aorta Abdominal/fisiopatología , Aneurisma de la Aorta Abdominal/terapia , Arteria Ilíaca/fisiología , Resistencia al Corte , Estrés Mecánico
5.
Artif Organs ; 40(12): 1137-1145, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27005487

RESUMEN

Histopathological analysis can provide important information in long-term experiments with total artificial heart (TAH). Recently, a new type of blood pump, the helical flow total artificial heart (HF-TAH) was developed. This study aimed to investigate the changes in selected vital organs in animal experiments with implanted HF-TAH. Samples from lung, liver, and kidneys from two female goats (No. 1301 and No. 1304) with implanted HF-TAH were analyzed. Tissue samples were fixed in 10% formaldehyde and 4 µm thick transverse sections were stained with hematoxylin-eosin (HE). Additional staining was done for detection of connective tissue (Masson-Goldner stain) and for detection of iron (hemosiderin) deposits (Perls stain). Sections were scanned at 100× and 500× magnification with a light microscope. Experiment no. 1301 survived 100 days (cause of termination was heavy damage of the right pump); experimental goat no.1304 survived 68 days and was sacrificed due to severe right hydrodynamic bearing malfunction. Histopathological analysis of liver samples proved signs of chronic venostasis with limited focal necrotic zones. Dilated tubules, proteinaceous material in tubular lumen, and hemosiderin deposits were detected in kidney samples. Contamination of the organs by embolized micro-particles was suspected at the autopsy after discovery of visible damage (scratches) of the pump impeller surface (made from titanium alloy) in both experiments. Sporadic deposits of foreign micro-particles (presumably titanium) were observed in most of the analyzed parenchymal organs. However, the described deposits were not in direct connection with inflammatory reactions in the analyzed tissues. Histopathological analysis showed the presence of minimal contamination of the lung, kidney, and liver tissue samples by foreign material (titanium very likely). The analysis showed only limited pathological changes, especially in liver and kidneys, which might be attributed to the influence of artificial perfusion often observed in chronic TAH experiments.


Asunto(s)
Corazón Artificial , Riñón/patología , Hígado/patología , Pulmón/patología , Animales , Femenino , Cabras , Corazón Artificial/efectos adversos , Diseño de Prótesis , Implantación de Prótesis/efectos adversos , Titanio/análisis
6.
Artif Organs ; 39(8): 670-80, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26234448

RESUMEN

Severe cardiac failure patients require a total artificial heart (TAH) to save life. To realize a TAH that can fit a body of small stature and has high performance, high durability, good anatomical fitting, good blood compatibility, and physiological control, we have been developing the helical flow TAH (HFTAH) with two helical flow pumps with hydrodynamic levitation impeller. Animal experiments of the HFTAH were conducted to perform in vivo studies. The HFTAH was implanted in 13 adult female goats weighing 45.0-64.0 kg. After surgery, neither anti-coagulant nor anti-platelet medication was given systemically. The HFTAH was usually driven with a quasi-pulsatile mode. The 1/R control or ΔP control was applied to control the circulation. The ΔP control is a new method using simplified equation of the 1/R control. The HFTAH could be implanted in all goats with good anatomical fitting. Two goats survived for a long time (100 and 68 days). Major causes of termination were device failure and surgical complications. In the device failure, trouble with hydrodynamic bearing was conspicuous. In the two long-term survived goats, experiments were terminated with bearing instability that was probably caused by the suction effect. In these goats, hemolysis occurred on postoperative day 88 and 44, which was considered to be relevant to the bearing trouble. Thrombus was found at the broken right bearing of the 100-day survived goat. However, antithrombogenicity of the pump is expected to be good unless bearing trouble occurs. In two long-term survived goats, the 1/R control or ΔP control worked appropriately to prevent the elevation of right atrial pressure. In both goats, hemodynamic parameters changed with the condition of the animals, liver and kidney functions remained almost normal except when recovering from surgery and during hemolysis, and total protein recovered 2 weeks after surgery. Although instability of the hydrodynamic bearing should be improved, performance of the HFTAH with physiological control could be demonstrated.


Asunto(s)
Corazón Artificial , Hemodinámica , Animales , Femenino , Cabras , Hemólisis , Ensayo de Materiales , Modelos Animales , Diseño de Prótesis , Falla de Prótesis , Flujo Pulsátil , Factores de Tiempo
7.
Materials (Basel) ; 17(5)2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38473539

RESUMEN

Microscale electronics have become increasingly more powerful, requiring more efficient cooling systems to manage the higher thermal loads. To meet this need, current research has been focused on overcoming the inefficiencies present in typical thermal management systems due to low Reynolds numbers within microchannels and poor physical properties of the working fluids. For the first time, this research investigated the effects of a connector with helical geometry on the heat transfer coefficient at low Reynolds numbers. The introduction of a helical connector at the inlet of a microchannel has been experimentally tested and results have shown that this approach to flow augmentation has a great potential to increase the heat transfer capabilities of the working fluid, even at low Reynolds numbers. In general, a helical connector can act as a stabilizer or a mixer, based on the characteristics of the connector for the given conditions. When the helical connector acts as a mixer, secondary flows develop that increase the random motion of molecules and possible nanoparticles, leading to an enhancement in the heat transfer coefficient in the microchannel. Otherwise, the heat transfer coefficient decreases. It is widely known that introducing nanoparticles into the working fluids has the potential to increase the thermal conductivity of the base fluid, positively impacting the heat transfer coefficient; however, viscosity also tends to increase, reducing the random motion of molecules and ultimately reducing the heat transfer capabilities of the working fluid. Therefore, optimizing the effects of nanoparticles characteristics while reducing viscous effects is essential. In this study, deionized water and deionized water-diamond nanofluid at 0.1 wt% were tested in a two-microchannel system fitted with a helical connector in between. It was found that the helical connector can make a great heat transfer coefficient enhancement in low Reynolds numbers when characteristics of geometry are optimized for given conditions.

8.
Acta Biomater ; 177: 216-227, 2024 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-38253303

RESUMEN

The effects of helical flow in a blood vessel are investigated in a dynamic flow generator using surface acoustic wave (SAW) in the microfluidic device. The SAW, generated by an interdigital transducer (IDT), induces acoustic streaming, resulting in a stable and consistent helical flow pattern in microscale channels. This approach allows rapid development of helical flow within the channel without directly contacting the medium. The precise design of the window enables the creation of distinct unidirectional vortices, which can be controlled by adjusting the amplitude of the SAW. Within this device, optimal operational parameters of the dynamic flow generator to preserve the integrity of endothelial cells are found, and in such settings, the actin filaments within the cells are aligned to the desired state. Our findings reveal that intracellular Ca2+ concentrations vary in response to flow conditions. Specifically, comparable maximum intensity and graphical patterns were observed between low-flow rate helical flow and high-flow rate Hagen-Poiseuille flow. These suggest that the cells respond to the helical flow through mechanosensitive ion channels. Finally, adherence of monocytes is effectively reduced under helical flow conditions in an inflammatory environment, highlighting the atheroprotective role of helical flow. STATEMENT OF SIGNIFICANCE: Helical flow in blood vessels is well known to prevent atherosclerosis. However, despite efforts to replicate helical flow in microscale channels, there is still a lack of in vitro models which can generate helical flow for analyzing its effects on the vascular system. In this study, we developed a method for generating steady and constant helical flow in microfluidic channel using acoustofluidic techniques. By utilizing this dynamic flow generator, we were able to observe the atheroprotective aspects of helical flow in vitro, including the enhancement of calcium ion flux and reduction of monocyte adhesion. This study paves the way for an in vitro model of dynamic cell culture and offers advanced investigation into helical flow in our circulatory system.


Asunto(s)
Aterosclerosis , Células Endoteliales , Humanos , Acústica , Microfluídica , Dispositivos Laboratorio en un Chip
9.
Heliyon ; 10(12): e33101, 2024 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-39021971

RESUMEN

The main objective of this study was to evaluate the impact of the length and retention time of a tubular helical flow flocculator (THFF) on the elimination of turbidity and color from raw water, to obtain quality treated water for consumption in areas rural. For this, a large-scale field experimental system was used, the THFF was built with 4-inch diameter polyethylene hose and coupled to a sedimentation and filtration process. For the different experimental tests, aluminum sulfate was chosen as the coagulant. To find the optimal dose of coagulant, jar tests were previously carried out. For the tests the length of the THFF was varied (50 m and 75 m), flow rates of 0.25, 0.5, 0.75, 1 and 2 L/s and turbidity ranges of <10, 10-20, 21-50, 51-100 and > 100 NTU of raw water were tested. An evaluation of the hydraulic behavior of the THFF was carried out through an analysis of the temporal distribution curve of the concentration of a tracer, applying the Wolf-Resnick model. The average results revealed a haze and color removal efficiency of 98.07 % and 98.50 %, respectively. The residence time and velocity gradient exhibited variations in a range of 2.25-35.0 min and 3.64 to 56.94 s-1, respectively. It was evident that the operation and effectiveness of THFF are directly influenced by the turbidity of the raw water, the residence time and the velocity gradient. These findings indicate that THFF could play a valuable role as a flocculation unit in a purification system, mainly the existence of a plug-type flow was observed. The findings indicate that THFF, complemented by settling and filtration processes, could be a valuable tool for implementation in rural areas.

10.
Cardiovasc Eng Technol ; 15(3): 317-332, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38315312

RESUMEN

PURPOSE: Altered hemodynamics caused by the presence of an endovascular device may undermine the success of peripheral stenting procedures. Flow-enhanced stent designs are under investigation to recover physiological blood flow patterns in the treated artery and reduce long-term complications. However, flow-enhanced designs require the development of customised manufacturing processes that consider the complex behaviour of Nickel-Titanium (Ni-Ti). While the manufacturing routes of traditional self-expanding Ni-Ti stents are well-established, the process to introduce alternative stent designs is rarely reported in the literature, with much of this information (especially related to shape-setting step) being commercially sensitive and not reaching the public domain, as yet. METHODS: A reliable manufacturing method was developed and improved to induce a helical ridge onto laser-cut and wire-braided Nickel-Titanium self-expanding stents. The process consisted of fastening the stent into a custom-built fixture that provided the helical shape, which was followed by a shape-setting in air furnace and rapid quenching in cold water. The parameters employed for the shape-setting in air furnace were thoroughly explored, and their effects assessed in terms of the mechanical performance of the device, material transformation temperatures and surface finishing. RESULTS: Both stents were successfully imparted with a helical ridge and the optimal heat treatment parameters combination was found. The settings of 500 °C/30 min provided mechanical properties comparable with the original design, and transformation temperatures suitable for stenting applications (Af = 23.5 °C). Microscopy analysis confirmed that the manufacturing process did not alter the surface finishing. Deliverability testing showed the helical device could be loaded onto a catheter delivery system and deployed with full recovery of the expanded helical configuration. CONCLUSION: This demonstrates the feasibility of an additional heat treatment regime to allow for helical shape-setting of laser-cut and wire-braided devices that may be applied to further designs.


Asunto(s)
Ensayo de Materiales , Níquel , Diseño de Prótesis , Titanio , Titanio/química , Níquel/química , Stents Metálicos Autoexpandibles , Rayos Láser , Propiedades de Superficie , Stents , Humanos
11.
Comput Biol Med ; 172: 108191, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38457932

RESUMEN

Bicuspid aortic valve (BAV), the most common congenital heart disease, is prone to develop significant valvular dysfunction and aortic wall abnormalities such as ascending aortic aneurysm. Growing evidence has suggested that abnormal BAV hemodynamics could contribute to disease progression. In order to investigate BAV hemodynamics, we performed 3D patient-specific fluid-structure interaction (FSI) simulations with fully coupled blood flow dynamics and valve motion throughout the cardiac cycle. Results showed that the hemodynamics during systole can be characterized by a systolic jet and two counter-rotating recirculation vortices. At peak systole, the jet was usually eccentric, with asymmetric recirculation vortices and helical flow motion in the ascending aorta. The flow structure at peak systole was quantified using the vorticity, flow rate reversal ratio and local normalized helicity (LNH) at four locations from the aortic root to the ascending aorta. The systolic jet was evaluated with the peak velocity, normalized flow displacement, and jet angle. It was found that peak velocity and normalized flow displacement (rather than jet angle) gave a strong correlation with the vorticity and LNH in the ascending aorta, which suggests that these two metrics could be used for clinical noninvasive evaluation of abnormal blood flow patterns in BAV patients.


Asunto(s)
Enfermedad de la Válvula Aórtica Bicúspide , Enfermedades de las Válvulas Cardíacas , Humanos , Válvula Aórtica/anomalías , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Aorta , Hemodinámica/fisiología
12.
Comput Methods Programs Biomed ; 230: 107331, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36621070

RESUMEN

BACKGROUND AND OBJECTIVE: The occurrence of acute type B aortic dissection (TBAD) remained unclear. This study aimed to investigate the association between flow features and hemodynamic parameters in aortas that demonstrated the risk of TBAD occurrence. METHODS: The geometries of 15 hyperacute TBAD and 12 control patients (with healthy aorta) were reconstructed from computed tomography angiography images. Pre-TBAD models were then obtained by eliminating the dissection flaps. Flow features and hemodynamic parameters, including wall shear stress-related parameters and helicities, were compared between pre-TBAD and control models using computational fluid dynamics. RESULTS: There were no significant differences in baseline characteristics and anatomical parameters between the two groups. Significant contralateral helical blood flow was present in the healthy thoracic aorta, while almost no helical flow was observed in the pre-TBAD group. In addition, the mean normal transverse wall shear stress (NtransWSS) was significantly higher in the pre-TBAD group (aortic arch 0.49±0.09 vs. 0.40±0.05, P = 0.04; descending aorta: 0.46±0.05 vs. 0.33±0.02, P<0.01). Moreover, a significantly negative correlation was found between helicity and NtransWSS in the descending aorta. Moreover, the location of primary tears in 12 pre-TABD subjects matched well with regions of high NtransWSS. CONCLUSIONS: Loss of helical flow in the aortic arch and descending aorta may be a major flow feature in patients with underlying TBAD, resulting in increased flow disturbance and wall lesions.


Asunto(s)
Aneurisma de la Aorta Torácica , Disección Aórtica , Humanos , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Disección Aórtica/diagnóstico por imagen , Aorta , Hemodinámica , Resultado del Tratamiento , Estudios Retrospectivos
13.
Comput Methods Programs Biomed ; 242: 107823, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37757568

RESUMEN

BACKGROUND: The combination of medical imaging and computational hemodynamics is a promising technology to diagnose/prognose coronary artery disease (CAD). However, the clinical translation of in silico hemodynamic models is still hampered by assumptions/idealizations that must be introduced in model-based strategies and that necessarily imply uncertainty. This study aims to provide a definite answer to the open question of how to properly model blood rheological properties in computational fluid dynamics (CFD) simulations of coronary hemodynamics. METHODS: The geometry of the right coronary artery (RCA) of 144 hemodynamically stable patients with different stenosis degree were reconstructed from angiography. On them, unsteady-state CFD simulations were carried out. On each reconstructed RCA two different simulation strategies were applied to account for blood rheological properties, implementing (i) a Newtonian (N) and (ii) a shear-thinning non-Newtonian (non-N) rheological model. Their impact was evaluated in terms of wall shear stress (WSS magnitude, multidirectionality, topological skeleton) and helical flow (strength, topology) profiles. Additionally, luminal surface areas (SAs) exposed to shear disturbances were identified and the co-localization of paired N and non-N SAs was quantified in terms of similarity index (SI). RESULTS: The comparison between paired N vs. shear-thinning non-N simulations revealed remarkably similar profiles of WSS-based and helicity-based quantities, independent of the adopted blood rheology model and of the degree of stenosis of the vessel. Statistically, for each paired N and non-N hemodynamic quantity emerged negligible bias from Bland-Altman plots, and strong positive linear correlation (r > 0.94 for almost all the WSS-based quantities, r > 0.99 for helicity-based quantities). Moreover, a remarkable co-localization of N vs. non-N luminal SAs exposed to disturbed shear clearly emerged (SI distribution 0.95 [0.93, 0.97]). Helical flow topology resulted to be unaffected by blood rheological properties. CONCLUSIONS: This study, performed on 288 angio-based CFD simulations on 144 RCA models presenting with different degrees of stenosis, suggests that the assumptions on blood rheology have negligible impact both on WSS and helical flow profiles associated with CAD, thus definitively answering to the question "is Newtonian assumption for blood rheology adequate in coronary hemodynamics simulations?".


Asunto(s)
Enfermedad de la Arteria Coronaria , Vasos Coronarios , Humanos , Vasos Coronarios/diagnóstico por imagen , Constricción Patológica , Hemodinámica , Reología , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Modelos Cardiovasculares , Estrés Mecánico , Velocidad del Flujo Sanguíneo/fisiología , Simulación por Computador
14.
Cardiovasc Eng Technol ; 14(1): 152-165, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36151366

RESUMEN

PURPOSE: Areas of disturbed shear that arise following arteriovenous fistula (AVF) creation are believed to contribute to the development of intimal hyperplasia (IH). The presence of helical flow can suppress areas of disturbed shear, which may protect the vasculature from IH. Therefore, the aim of this study is to determine if helical flow, specifically spiral laminar flow (SLF), is present in patient-specific AVF models and is associated with a reduction in exposure to disturbed shear. METHODS: Four AVF were imaged using MRI within the first two weeks following fistula creation. Patient-specific boundary conditions were obtained using phase-contrast MRI and applied at the inlet and outlets of each model. Computational fluid dynamics was used to analyse the hemodynamics in each model and compare the helical content of the flow to the distribution of disturbed shear. RESULTS: BC-1 and RC-2 are characterised by the presence of SLF, which coincides with the lowest distribution of disturbed shear. Contrastingly, SLF is absent from BC-2 and RC-1 and experience the largest amount of disturbed shear. Interestingly, BC-2 and RC-1 developed an anastomosis stenosis, while BC-1 and RC-2 remained stenosis free. CONCLUSION: These findings are in agreement with previous clinical studies and further highlight the clinical potential of SLF as a prognostic marker for a healthy AVF, as its presence correlates with an overall reduction in exposure to disturbed shear and a decrease in the incidence of AVF dysfunction, albeit in a small sample size.


Asunto(s)
Fístula Arteriovenosa , Derivación Arteriovenosa Quirúrgica , Humanos , Hemodinámica , Fístula Arteriovenosa/diagnóstico por imagen , Anastomosis Quirúrgica , Imagen por Resonancia Magnética , Derivación Arteriovenosa Quirúrgica/efectos adversos , Diálisis Renal
15.
J Biomech ; 154: 111620, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37178494

RESUMEN

In the context of aortic hemodynamics, uncertainties affecting blood flow simulations hamper their translational potential as supportive technology in clinics. Computational fluid dynamics (CFD) simulations under rigid-walls assumption are largely adopted, even though the aorta contributes markedly to the systemic compliance and is characterized by a complex motion. To account for personalized wall displacements in aortic hemodynamics simulations, the moving-boundary method (MBM) has been recently proposed as a computationally convenient strategy, although its implementation requires dynamic imaging acquisitions not always available in clinics. In this study we aim to clarify the real need for introducing aortic wall displacements in CFD simulations to accurately capture the large-scale flow structures in the healthy human ascending aorta (AAo). To do that, the impact of wall displacements is analyzed using subject-specific models where two CFD simulations are performed imposing (1) rigid walls, and (2) personalized wall displacements adopting a MBM, integrating dynamic CT imaging and a mesh morphing technique based on radial basis functions. The impact of wall displacements on AAo hemodynamics is analyzed in terms of large-scale flow patterns of physiological significance, namely axial blood flow coherence (quantified applying the Complex Networks theory), secondary flows, helical flow and wall shear stress (WSS). From the comparison with rigid-wall simulations, it emerges that wall displacements have a minor impact on the AAo large-scale axial flow, but they can affect secondary flows and WSS directional changes. Overall, helical flow topology is moderately affected by aortic wall displacements, whereas helicity intensity remains almost unchanged. We conclude that CFD simulations with rigid-wall assumption can be a valid approach to study large-scale aortic flows of physiological significance.


Asunto(s)
Aorta Torácica , Aorta , Humanos , Aorta Torácica/fisiología , Aorta/fisiología , Hemodinámica/fisiología , Estrés Mecánico , Modelos Cardiovasculares , Velocidad del Flujo Sanguíneo/fisiología
16.
Front Cardiovasc Med ; 10: 1216796, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37719972

RESUMEN

Background: Computational fluid dynamics (CFD) is emerging as an effective technology able to improve procedural outcomes and enhance clinical decision-making in patients with coronary artery disease (CAD). The present study aims to assess the state of knowledge, use and clinical acceptability of CFD in the diagnosis and treatment of CAD. Methods: We realized a 20-questions international, anonymous, cross-sectional survey to cardiologists to test their knowledge and confidence on CFD as a technology applied to patients suffering from CAD. Responses were recorded between May 18, 2022, and June 12, 2022. Results: A total of 466 interventional cardiologists (mean age 48.4 ± 8.3 years, males 362), from 42 different countries completed the survey, for a response rate of 45.9%. Of these, 66.6% declared to be familiar with the term CFD, especially for optimization of existing interventional techniques (16.1%) and assessment of hemodynamic quantities related with CAD (13.7%). About 30% of respondents correctly answered to the questions exploring their knowledge on the pathophysiological role of some CFD-derived quantities such as wall shear stress and helical flow in coronary arteries. Among respondents, 85.9% would consider patient-specific CFD-based analysis in daily interventional practice while 94.2% declared to be interested in receiving a brief foundation course on the basic CFD principles. Finally, 87.7% of respondents declared to be interested in a cath-lab software able to conduct affordable CFD-based analyses at the point-of-care. Conclusions: Interventional cardiologists reported to be profoundly interested in adopting CFD simulations as a technology supporting decision making in the treatment of CAD in daily practice.

17.
Diagnostics (Basel) ; 13(12)2023 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-37371010

RESUMEN

We aimed to explore the feasibility of 4D flow magnetic resonance imaging (MRI) for patients undergoing thoracic aorta endovascular repair (TEVAR). We retrospectively evaluated ten patients (two female), with a mean (±standard deviation) age of 61 ± 20 years, undergoing MRI for a follow-up after TEVAR. All 4D flow examinations were performed using a 1.5-T system (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany). In addition to the standard examination protocol, a 4D flow-sensitive 3D spatial-encoding, time-resolved, phase-contrast prototype sequence was acquired. Among our cases, flow evaluation was feasible in all patients, although we observed some artifacts in 3 out of 10 patients. Three individuals displayed a reduced signal within the vessel lumen where the endograft was placed, while others presented with turbulent or increased flow. An aortic endograft did not necessarily hinder the visualization of blood flow through 4D flow sequences, although the graft could generate flow artifacts in some cases. A 4D Flow MRI may represent the ideal tool to follow up on both healthy subjects deemed to be at an increased risk based on their anatomical characteristics or patients submitted to TEVAR for whom a surveillance protocol with computed tomography angiography would be cumbersome and unjustified.

18.
J Chromatogr A ; 1685: 463623, 2022 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-36347074

RESUMEN

Open-Tubular Liquid Chromatography (OTLC) is currently limited by two shortcomings, namely the low ratio of adsorbing area to the channel volume and the large values of the Height Equivalent of the Theoretical Plate (HETP) due to Taylor-Aris dispersion. Previous work focusing on axial dispersion of nonadsorbing solutes showed how it is possible to tame the Taylor-Aris effect by inducing transversal velocity components acting alongside the main pressure-driven axial flow. We here analyze the impact of transversal flow on the separation resolution in OTLC, where simultaneous equilibrium adsorption at the channel walls is superimposed to the analyte transport in the mobile phase. A three-dimensional steady flow generated by the combination of a pressure-driven flow and an electroosmotically-induced transversal flow is used as case study. Flows geometries possessing regular and chaotic streamlines are created by axially-invariant and periodically-alternate arrangements of the electrodes along the channel walls, respectively. By enforcing Brenner's macrotransport approach, we predict the column length achieving a prescribed level of resolution as a function of the Péclet number and of the species affinity towards the stationary adsorbing phase. Results show that the presence of transversal flows can lower sensitively the dependence of the column length on the Péclet number. Flows possessing chaotic streamlines prove the most efficient choice at large eluent velocities and low values of the column adsorption constant.


Asunto(s)
Cromatografía Liquida , Cromatografía Liquida/métodos , Adsorción
19.
Insights Imaging ; 13(1): 192, 2022 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-36512292

RESUMEN

BACKGROUND: Marked changes in hemodynamics have been suggested to be a potential contributing factor to portal vein thrombosis (PVT) development. This study investigated the effect of portal hemodynamics based on the anatomical structure of the portal venous system on PVT development. METHODS: The morphological features of portal venous system in patients with PVT and those without PVT subgroups were compared. In addition, idealized PV models were established to numerically evaluate the effect of the variation in the angulation of superior mesenteric vein (SMV) and splenic vein (SV) on the hemodynamics of portal venous system. RESULTS: The angle α (angulation of SMV and SV) in patients with PVT was lower than that in patients without PVT (p < 0.0001), which was the only independent risk factor (odds ratio (OR), 0.90 (95% CI 0.84-0.95); p < 0.0001) for the presence of PVT. With the change in angle α, the flow pattern of blood flow changed greatly, especially the helical flow. When α = 80°, helical flow only appeared at the local PV near the intersection of SMV and SV. When α = 120°, most regions were occupied by the helical flow. In addition, the h2 gradually increased with increasing α, when α = 80°, h2 = 12.6 m/s2; when α = 120°, h2 = 29.3 m/s2. CONCLUSIONS: The angulation of SV and SMV was closely associated with PVT development. Helical flow changed following the varying angulation of SV and SMV. Therefore, angulation of SV and SMV may help to identify high-risk cohorts for future PVT development earlier.

20.
Comput Methods Programs Biomed ; 221: 106882, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35597205

RESUMEN

BACKGROUND AND OBJECTIVES: The translation of hemodynamic quantities based on wall shear stress (WSS) or intravascular helical flow into clinical biomarkers of coronary atherosclerotic disease is still hampered by the assumptions/idealizations required by the computational fluid dynamics (CFD) simulations of the coronary hemodynamics. In the resulting budget of uncertainty, inflow boundary conditions (BCs) play a primary role. Accordingly, in this study we investigated the impact of the approach adopted for in vivo coronary artery blood flow rate assessment on personalized CFD simulations where blood flow rate is used as inflow BC. METHODS: CFD simulations were carried out on coronary angiograms by applying personalized inflow BCs derived from four different techniques assessing in vivo surrogates of flow rate: continuous thermodilution, intravascular Doppler, frame count-based 3D contrast velocity, and diameter-based scaling law. The impact of inflow BCs on coronary hemodynamics was evaluated in terms of WSS- and helicity-based quantities. RESULTS: As main findings, we report that: (i) coronary flow rate values may differ based on the applied flow derivation technique, as continuous thermodilution provided higher flow rate values than intravascular Doppler and diameter-based scaling law (p = 0.0014 and p = 0.0023, respectively); (ii) such intrasubject differences in flow rate values lead to different surface-averaged values of WSS magnitude and helical blood flow intensity (p<0.0020); (iii) luminal surface areas exposed to low WSS and helical flow topological features showed robustness to the flow rate values. CONCLUSIONS: Although the absence of a clinically applicable gold standard approach prevents a general recommendation for one coronary blood flow rate derivation technique, our findings indicate that the inflow BC may impact computational hemodynamic results, suggesting that a standardization would be desirable to provide comparable results among personalized CFD simulations of the coronary hemodynamics.


Asunto(s)
Enfermedad de la Arteria Coronaria , Modelos Cardiovasculares , Velocidad del Flujo Sanguíneo , Hemodinámica/fisiología , Humanos , Hidrodinámica , Estrés Mecánico
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