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Hemodynamic Implications of Aortic Stenosis on Ascending Aortic Aneurysm Progression: A Patient-Specific CFD Study

Year: 2025

Type: article

Abstract: An ascending aortic aneurysm is a localized dilation of the ascending aorta, which poses a high risk of aortic dissection or rupture, with surgery recommended at diameters > 5.5 cm. However, events also occur at smaller sizes, suggesting additional factors—such as stenosis—may significantly influence aneurysm severity. To investigate this, a computational fluid dynamics (CFD) analysis was conducted using a patient-specific ascending aortic model (aneurysm diameter: 5.28 cm) under three aortic stenosis severities: mild, moderate, and severe. Results showed that the severe stenosis condition led to the formation of prominent recirculation zones and increased peak velocities, 2.36 m·s−1 compared to 1.53 m·s−1 for moderate stenosis and 1.37 m·s−1 for mild stenosis. A significantly increased pressure loss coefficient was observed for the severe case. Additionally, the wall shear stress (WSS) distribution exhibited higher values along the anterior region and lower values along the posterior region. Peak WSS values were recorded at 43.46 Pa in the severe stenosis model, compared to 21.98 Pa and 13.87 Pa for the moderate and mild cases, respectively. Velocity distribution and helicity analyses demonstrate that increasing stenosis severity amplifies jet-induced flow disturbances, contributing to larger recirculation zones and greater helicity heterogeneity in the ascending aorta. Meanwhile, WSS results indicate that greater stenosis severity is also associated with elevated WSS magnitude and heterogeneity in the ascending aorta, with severe cases exhibiting the highest value. These findings highlight the need to incorporate hemodynamic metrics, alongside traditional diameter-based criteria, into rupture risk assessment frameworks.

Source: Journal of Vascular Diseases

DOI: 10.3390/jvd4040038

Authors: A B M Nazmus Salehin Nahid, Mashrur Muntasir Nuhash, Ruihang Zhang

Institution: University of Minnesota, Duluth

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,207