Document Detail

Computational simulations for aortic coarctation: representative results from a sampling of patients.
MedLine Citation:
PMID:  22010743     Owner:  NLM     Status:  MEDLINE    
Treatments for coarctation of the aorta (CoA) can alleviate blood pressure (BP) gradients (Δ), but long-term morbidity still exists that can be explained by altered indices of hemodynamics and biomechanics. We introduce a technique to increase our understanding of these indices for CoA under resting and nonresting conditions, quantify their contribution to morbidity, and evaluate treatment options. Patient-specific computational fluid dynamics (CFD) models were created from imaging and BP data for one normal and four CoA patients (moderate native CoA: Δ12 mmHg, severe native CoA: Δ25 mmHg and postoperative end-to-end and end-to-side patients: Δ0 mmHg). Simulations incorporated vessel deformation, downstream vascular resistance and compliance. Indices including cyclic strain, time-averaged wall shear stress (TAWSS), and oscillatory shear index (OSI) were quantified. Simulations replicated resting BP and blood flow data. BP during simulated exercise for the normal patient matched reported values. Greatest exercise-induced increases in systolic BP and mean and peak ΔBP occurred for the moderate native CoA patient (SBP: 115 to 154 mmHg; mean and peak ΔBP: 31 and 73 mmHg). Cyclic strain was elevated proximal to the coarctation for native CoA patients, but reduced throughout the aorta after treatment. A greater percentage of vessels was exposed to subnormal TAWSS or elevated OSI for CoA patients. Local patterns of these indices reported to correlate with atherosclerosis in normal patients were accentuated by CoA. These results apply CFD to a range of CoA patients for the first time and provide the foundation for future progress in this area.
John F LaDisa; C Alberto Figueroa; Irene E Vignon-Clementel; Hyun Jin Kim; Nan Xiao; Laura M Ellwein; Frandics P Chan; Jeffrey A Feinstein; Charles A Taylor
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of biomechanical engineering     Volume:  133     ISSN:  1528-8951     ISO Abbreviation:  J Biomech Eng     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-10-20     Completed Date:  2012-02-15     Revised Date:  2013-08-16    
Medline Journal Info:
Nlm Unique ID:  7909584     Medline TA:  J Biomech Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  091008     Citation Subset:  IM    
Department of Biomedical Engineering, Marquette University, Milwaukee, WI 53233, USA.
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MeSH Terms
Aortic Coarctation / pathology,  physiopathology*,  surgery
Child, Preschool
Computer Simulation*
Magnetic Resonance Imaging
Models, Anatomic
Postoperative Period
Stress, Mechanical
Grant Support

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