Parametric Investigations of the Induced Shear Stress by a Laser-Generated Bubble.

The present paper focuses on the simulation of the growth and collapse of a bubble in the vicinity of a wall. Both liquid and gas phases are assumed compressible, and their interaction is handled with the volume-of-fluid method. The main interest is to quantify the influence of the induced shear stress and pressure pulse in the vicinity of the wall for a variety of bubble sizes and bubble-wall distances. The results are validated against prior experimental results, such as the measurements of the bubble size, induced pressure field, and shear stress on the wall. The simulation predictions indicate that the wall in the vicinity of the bubble is subjected both to high shear stresses and large pressure pulses because of the growth and collapse of the bubble. In fact, pressure levels of 100 bar or more and shear stresses up to 25 kPa have been found at localized spots on the wall surface, at the region around the bubble. Moreover, the simulations are capable of providing additional insight to the experimental investigation, as the inherent limitations of the latter are avoided. The present work may be considered as a preliminary investigation in optimizing bubble energy and wall generation distance for ultrasound cleaning applications.

A new method of three-dimensional coronary artery reconstruction from X-ray angiography: validation against a virtual phantom and multislice computed tomography.

OBJECTIVE: To develop and implement a method for three-dimensional (3D) reconstruction of coronary arteries from conventional monoplane angiograms. BACKGROUND: 3D reconstruction of conventional coronary angiograms is a promising imaging modality for both diagnostic and interventional purposes. METHODS: Our method combines image enhancement, automatic edge detection, an iterative method to reconstruct the centerline of the artery and reconstruction of the diameter of the vessel by taking into consideration foreshortening effects. The X-Ray-based 3D coronary trees were compared against phantom data from a virtual arterial tree projected into two planes as well as computed tomography (CT)-based coronary artery reconstructions in patients subjected to coronary angiography. RESULTS: Comparison against the phantom arterial tree demonstrated perfect agreement with the developed algorithm. Visual comparison against the CT-based reconstruction was performed in the 3D space, in terms of the direction angle along the centerline length of the left anterior descending and circumflex arteries relative to the main stem, and location and take-off angle of sample bifurcation branches from the main coronary arteries. Only minimal differences were detected between the two methods. Inter- and intraobserver variability of our method was low (intra-class correlation coefficients > 0.8). CONCLUSION: The developed method for coronary artery reconstruction from conventional angiography images provides the geometry of coronary arteries in the 3D space.

Aortic Flow Patterns After Simulated Implantation of Transcatheter Aortic Valves.

INTRODUCTION: The functional behavior and hemodynamic characteristics of percutaneously implanted bioprosthetic valves are not known. METHODS: We created aortic models after the simulated implantation of two of the most widely used bioprosthetic valves: the Edwards SAPIEN, and the Medtronic CoreValve. By using computational fluid dynamics analysis we sought to investigate variations in the aortic flow patterns induced by the two valve designs and their association with detrimental phenomena such as vascular remodeling, vascular wall damage and thrombosis. RESULTS: The simulated implantation of models that resemble the two valves resulted in different aortic flow conditions. Vortex formation in the upper ascending aorta was more persistent in the case of the simulated Medtronic valve. The ranges of average wall shear stress (WSS) values were 2.4-3.5 Pa for Edwards and 3.0-5.3 Pa for Medtronic; the calculated WSS values induced endothelial quiescence and an atheroprotective setting in both valves. The average shear stress on the simulated valve leaflets was low; however, hotspots were present in both valves (155.0 Pa for Edwards and 250.0 Pa for Medtronic) which would in theory be able to cause platelet activation and thus promote thrombosis. The pressure drops along the aorta were slightly lower for the Edwards compared to the Medtronic valve (198.0 Pa versus 218.0 Pa). CONCLUSIONS: The presented method allows the assessment of aortic flow conditions following the implantation of bioprosthetic valves. It may be useful in predicting detrimental flow phenomena, thus facilitating the selection of appropriate valve designs.

Flow patterns at stented coronary bifurcations: computational fluid dynamics analysis.

BACKGROUND: The ideal bifurcation stenting technique is not established, and data on the hemodynamic characteristics at stented bifurcations are limited. METHODS AND RESULTS: We used computational fluid dynamics analysis to assess hemodynamic parameters known affect the risk of restenosis and thrombosis at coronary bifurcations after the use of various single- and double-stenting techniques. We assessed the distributions and surface integrals of the time averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (t(r)). Single main branch stenting without side branch balloon angioplasty or stenting provided the most favorable hemodynamic results (integrated values of TAWSS=4.13·10(-4) N, OSI=7.52·10(-6) m(2), t(r)=5.57·10(-4) m(2)/Pa) with bifurcational area subjected to OSI values >0.25, >0.35, and >0.45 calculated as 0.36 mm(2), 0.04 mm(2), and 0 mm(2), respectively. Extended bifurcation areas subjected to these OSI values were seen after T-stenting: 0.61 mm(2), 0.18 mm(2), and 0.02 mm(2), respectively. Among the considered double-stenting techniques, crush stenting (integrated values of TAWSS=1.18·10(-4) N, OSI=7.75·10(-6) m(2), t(r)=6.16·10(-4) m(2)/Pa) gave the most favorable results compared with T-stenting (TAWSS=0.78·10(-4) N, OSI=10.40·10(-6) m(2), t(r)=6.87·10(-4) m(2)/Pa) or the culotte technique (TAWSS=1.30· 10(-4) N, OSI=9.87·10(-6) m(2), t(r)=8.78·10(-4) m(2)/Pa). CONCLUSIONS: In the studied models of computer simulations, stenting of the main branch with our without balloon angioplasty of the side branch offers hemodynamic advantages over double stenting. When double stenting is considered, the crush technique with the use of a thin-strut stent may result in improved immediate hemodynamics compared with culotte or T-stenting.