Document Detail


Computational fluid dynamic simulations of aortic coarctation comparing the effects of surgical- and stent-based treatments on aortic compliance and ventricular workload.
MedLine Citation:
PMID:  21061250     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In this work, we examine the effects of stent-induced aortic stiffness on cardiac workload and blood pressure using computational fluid dynamic simulations.
BACKGROUND: Treatment of aortic coarctation (CoA) consists of either open, surgical repair or angioplasty with or without stenting. Although stenting is a minimally invasive alternative to surgery, aortic stiffness increases in the stented section. Concern over this increased stiffness has long been argued to be detrimental to the overall vascular health of the patient.
METHODS: MR imaging was performed on a 15-year-old female with CoA. A 3D model of the large thoracic arteries was created, and the heart and downstream vasculature were represented by lumped parameter models at the model inlet and outlets, respectively. A deformable wall assumption was used in conjunction with variable wall properties and tissue support, and 3D velocity, pressure, and wall dynamics were computed. The lumped parameter values and wall properties were tuned to match the mean flow and aortic deformation as measured by MRI. The CoA was then virtually removed from the model representing an end-to-end surgical correction. In a second model, the repaired section was prescribed to be nearly rigid, representing stenting. All other variables remained the same.
RESULTS: When compared to surgery, stenting resulted in clinically negligible increases in cardiac work (0.4%) and no change in mean blood pressure.
CONCLUSIONS: This pilot study suggests CoA stenting may not affect cardiac work to any significant degree as is commonly believed in the clinical community.
Authors:
Jessica Shih Coogan; Frandics Pak Chan; Charles Anthony Taylor; Jeffrey Allan Feinstein
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-03-21
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-24     Completed Date:  2011-07-18     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  680-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley-Liss, Inc.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aorta / physiopathology,  surgery*
Aortic Coarctation / physiopathology,  surgery,  therapy*
Blood Flow Velocity
Blood Pressure
Compliance
Endovascular Procedures / instrumentation*
Female
Humans
Image Interpretation, Computer-Assisted
Imaging, Three-Dimensional
Magnetic Resonance Angiography
Models, Cardiovascular*
Molecular Dynamics Simulation*
Pilot Projects
Regional Blood Flow
Stents*
Time Factors
Treatment Outcome
Vascular Surgical Procedures*
Ventricular Function*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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