Girardin, Louis;
(2025)
Patient-specific CFD workflows for haemodynamics assessment of Aortic Dissection interventions informed by multi-modal clinical data.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Type-B Aortic Dissection (TBAD) is a severe cardiovascular disease caused by a tear in the descending aorta, creating an intimal flap (IF) that separates the aortic wall into two lumina. This condition leads to complications such as aortic growth, increased pressure, and partial thrombosis, posing significant risks to patient health. While surgical intervention is often necessary to prevent adverse outcomes, the impact of such procedures and their long-term effects remain poorly understood, highlighting the need for improved tools to guide treatment and follow-up. The coupling of compliant CFD simulations with clinical data, such as MRI images, helps mitigating the limitations of each method. Such pipeline can be used to assess aortic haemodynamics and compliance behaviour, particularly post-surgery when mismatches occur between the native vessel and the implanted device. However, numerous assumptions regarding material properties and the multi-compliance of the reconstructed TBAD, fail to capture physiological dynamics and limit the clinical relevance of the simulation results. The present thesis presents computational pipelines, bypassing the aforementioned limitations, in which compliant CFD simulations enhance routine patient-specific in vivo data, enabling the exploration of virtual surgeries and their effects on TBAD haemodynamics and compliance. Different grafting strategies with varying graft lengths and compliance were first evaluated in a chronic dissection case to assess the impact of compliance mismatch on heart and left ventricular load. Next, a multi-compliant modelling framework was used to evaluate the impact of IF compliance on haemodynamics and disease progression risks. Finally, a method using the pulse wave velocity, a routinely used clinical marker, was used in a patient-specific CFD workflow and facilitated the agreements against in vivo data. This thesis complements efforts in addressing critical modelling assumptions and introducing advanced computational pipelines, this thesis contributes to enhancing the accuracy and clinical applicability of CFD simulations in the assessment and treatment of TBAD, ultimately improving patient-specific outcomes and guiding surgical decision-making.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Patient-specific CFD workflows for haemodynamics assessment of Aortic Dissection interventions informed by multi-modal clinical data |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214038 |
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