Assessment of Rheological Models Applied to Blood Flow in Human Thoracic Aorta.

PURPOSE: The purpose of this study is to assess the importance of non-Newtonian rheological models on blood flow in the human thoracic aorta. METHODS: The pulsatile flow in the aorta is simulated using the models of Casson, Quemada and Walburn-Schneck in addition to a case of fixed (Newtonian) viscosity. The impact of the four rheological models (using constant hematocrit) was assessed with respect to (i) magnitude and deviation of the viscosity relative to a reference value (the Newtonian case); (ii) wall shear stress (WSS) and its time derivative; (iii) common WSS-related indicators, OSI, TAWSS and RRT; (iv) relative volume and surface-based retrograde flow; and (v) the impact of rheological models on the transport of small particles in the thoracic aorta. RESULTS: The time-dependent flow in the thoracic aorta implies relatively large variations in the instantaneous WSS, due to variations in the instantaneous viscosity by as much as an order of magnitude. The largest effect was observed for low shear rates (tens s-1). The different viscosity models had a small impact in terms of time- and spaced-averaged quantities. The significance of the rheological models was clearly demonstrated in the instantaneous WSS, for the space-averaged WSS (about 10%) and the corresponding temporal derivative of WSS (up to 20%). The longer-term accumulated effect of the rheological model was observed for the transport of spherical particles of 2 mm and 2 mm in diameter (density of 1200 kg/m3). Large particles' total residence time in the brachiocephalic artery was 60% longer compared to the smaller particles. For the left common carotid artery, the opposite was observed: the smaller particles resided considerably longer than their larger counterparts. CONCLUSIONS: The dependence on the non-Newtonian properties of blood is mostly important at low shear regions (near walls, stagnation regions). Time- and space-averaging parameters of interest reduce the impact of the rheological model and may thereby lead to under-estimation of viscous effects. The rheological model affects the local WSS and its temporal derivative. In addition, the transport of small particles includes the accumulated effect of the blood rheological model as the several forces (e.g., drag, added mass and lift) acting on the particles are viscosity dependent. Mass transport is an essential factor for the development of pathologies in the arterial wall, implying that rheological models are important for assessing such risks.

Effects of aortic irregularities on blood flow.

Anatomic aortic anomalies are seen in many medical conditions and are known to cause disturbances in blood flow. Turner syndrome (TS) is a genetic disorder occurring only in females where cardiovascular anomalies, particularly of the aorta, are frequently encountered. In this study, numerical simulations are applied to investigate the flow characteristics in four TS patient- related aortic arches (a normal geometry, dilatation, coarctation and elongation of the transverse aorta). The Quemada viscosity model was applied to account for the non-Newtonian behavior of blood. The blood is treated as a mixture consisting of water and red blood cells (RBC) where the RBCs are modeled as a convected scalar. The results show clear geometry effects where the flow structures and RBC distribution are significantly different between the aortas. Transitional flow is observed as a jet is formed due to a constriction in the descending aorta for the coarctation case. RBC dilution is found to vary between the aortas, influencing the WSS. Moreover, the local variations in RBC volume fraction may induce large viscosity variations, stressing the importance of accounting for the non-Newtonian effects.

Atherosclerotic indicators for blood-like fluids in 90-degree arterial-like bifurcations.

The identification of regions prone to atherogenesis in the arterial network is compounded by the complex, slow interaction of mechanical and biomechanical processes. In recent times simplifications to the analysis of the near wall hemodynamics have been sought-after to identify plaque prone regions. Mean parameters have been defined to analyze the common fluid mechanical hypotheses considering the role of wall shear stress (WSS) variations in the pathological changes to the endothelium. In this study well known WSS indicators are applied to varying flow conditions of blood-like fluids in a 90-degree arterial bifurcation. The conventional indicators identify two distinct, focal regions that correlate with a known plaque prone location near arterial bifurcations. The results however demonstrate that the interpretation of the indicators can be difficult under varying flow conditions unless complementary parameters are considered simultaneously. A new indicator is also suggested that extracts the peaks of the temporal WSS gradients (PTWSSGs) and is shown to co-incide well with plaque prone regions. The PTWSSG could be used as a complimentary atherogenic indicator in bifurcating arteries, thereby expanding cardiovascular disease studies to the consideration of alternative fluid mechanical hypotheses. The inclusion of a non-Newtonian model is important in predicting the WSS and temporal WSS gradient distributions near the bifurcation due to the separation bubble induced fluctuations in the shear. Atherogenic indicators could be misleading if non-Newtonian effects are excluded.

Wall shear stress variations and unsteadiness of pulsatile blood-like flows in 90-degree bifurcations.

Complex and slow interaction of different mechanical and biochemical processes in hemodynamics is believed to govern atherogenesis. Over the last decades studies have shown that fluid mechanical factors such as the Wall Shear Stress (WSS) and WSS gradients can play an important role in the pathological changes of the endothelium. This study provides further indications that the effects of fluid mechanical aspects are correlated with the diseased regions of the larger arteries. Unsteady high temporal WSS gradients (TWSSG), a function of the shear-thinning property of the non-Newtonian viscosity, move with the separation bubble. Red Blood Cell (RBC) dilution due to the secondary flows determines the magnitudes of the WSS and TWSSG. The results indicate that the focal nature of the TWSSG may have implications on the response of the endothelium.

Planning human upper airway surgery using computational fluid dynamics.

The study advances the idea of using computational fluid dynamics in the process of planning surgical treatment modalities for patients with obstructive airway disorders. It is hypothesized that the a priori knowledge of the functional outcome of surgical intervention on the flow and airway resistance can guide the surgeon in choosing an effective surgical strategy. Computed tomography images spanning the respiratory tract of an adult patient with a combined glottic and subglottic stenosis are used to reconstruct three-dimensional geometrical models of the airway. Computational fluid dynamics is used to obtain airway flow patterns during inspiration and expiration in these models. Numerical predictions about flow velocity, pressure distribution on the airway lumen, wall shear stress, and airway resistance are obtained so that the relevance of each individual stenotic level is quantified. Four different virtual surgeries in different combinations are assessed in order to remedy the constricted airway. The virtual surgery based airway models are evaluated by comparisons with the pre-treatment flow modeling results. The predicted numerical data revealed that the removal of the constriction at the level of the vocal folds will have the most significant effect on the airway resistance. The flow simulations offer a quantitative method of evaluating the airway resistance in patients with combined glottic and subglottic stenoses. Predictions of airway resistances and other numerical calculations from different virtual surgeries give additional inputs for the surgeon, in deciding the most appropriate surgery on a case-by-case basis.

Wall shear stress variations in a 90-degree bifurcation in 3D pulsating flows.

The exact role of fluid mechanics in the patho-physiological process of atherosclerosis has been a research topic over many years, yet without clear conclusive result. One has observed that morphological manifestations of the disease are found at some well-defined locations: certain vessel bifurcations and in curvatures. The flow in these regions is characterized by unsteadiness and often separation. Currently there are no complete theories that can explain the process since the different components in the process are not fully understood. Here we carry out detailed computations of the unsteady flow in an arterial segment typical to location of early appearance of arterial lesions. We study the wall shear stress (WSS) field variations near a junction with the purpose of identifying fluid-mechanical parameters that can be related to sites of atherosclerosis. The results show that regions associated with atherosclerosis experience highly elevated temporal- and spatial-derivatives of the WSS, also at less commonly known locations. Thus, large derivatives in time and space do not seem unique for the most common areas of atherosclerosis. Differences in WSS character between these locations are identified as differences in the time period of back flow as well as differences in the magnitude of the WSS derivatives. The data is presented in a way that facilitates understanding of the variations in WSS.

Dosin--a new pump device. Its construction and function.

The cyclic flow of the Dosin is useful in interventional radiology since it prevents clotting and increases the mixing with the blood. The flow rate varies from 0.03 mL/s to 5 mL/s and it is recommended to use fluid with a viscosity lower than 3 mPa.s. The outlet pressure is recommended below 300 mm Hg. The Dosin must be replaced after each patient, alternatively after maximum 24h continuous use.