Thoracic endovascular aortic repair for acute aortic dissection complicated by mesenteric malperfusion: an evaluation by computational fluid dynamics.

Computational fluid dynamics was performed to simulate haemodynamics of type B aortic dissection complicated by mesenteric malperfusion caused by dynamic obstruction in a 70-year-old man. Streamline analysis showed disappearance of antegrade flow in the false lumen of the descending aorta and attenuation of intermittent flap-induced disruption of visceral vessel perfusion after entry coverage. Quantitative analysis showed endovascular repair increased perfusion volume of the coeliac artery and superior mesenteric artery by 55.6% and 77.4%, respectively. Entry closure with thoracic endovascular prosthesis improved mesenteric malperfusion by attenuating the intermittent flap-induced perfusion disruption.