Artery Dissection

An arterial dissection is a tear of the delicate internal lining in the artery. It causes serious damage and is of significant interests to surgeons. When this happens in coronary artery, it leads to myocardial infarction with a high rate of modality. Although arterial dissection is a frequently occurring phenomenon and a challenging clinical entity the underlying biomechanics remains largely unclear.

In this project, we will address an particular situation of aortic dissection associated with patients with congenitally bicuspid aortic valve. A congenitally bicuspid aortic valve has 2 functional leaflets instead of 3 leaflets. Bicuspid aortic valve is often observed with other left-sided obstructive lesions such as coarctation of the aorta or interrupted aortic arch, and dilated aortic root. This dilatation has some similarities to the dilatation of the aorta seen in Marfan syndrome. The dilatation may involve the ascending aorta (most commonly) but may also involve the aortic root or transverse aortic arch. It is presumably due to the weakened aorta, patients with bicuspid aortic valve is particularly prone to artery dissection.
We will derive analytical solutions for simplified artery dissection models using a novel (cohesive zone) approach to resolve the crack (dissection) propagation in the arterial wall embedded in fluid (blood). The simplified models will be used to develop more realistic physiological models using numerical methods and MRI, and results will be compared with with Glasgow clinical database of patients with congenitally bicuspid aortic valve. The project will identify the key factors contributing to the higher rate of arterial dissection in this patient group.

This work is in collaboration with