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The Impact of MRI-based Inflow for the Hemodynamic Evaluation of Aortic Coarctation

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Abstract

Aortic coarctation (CoA) accounting for 3–11% of congenital heart disease can be successfully treated. Long-term results, however, have revealed decreased life expectancy associated with abnormal hemodynamics. Accordingly, an assessment of hemodynamics is the key factor in treatment decisions and successful long-term results. In this study, 3D angiography whole heart (3DWH) and 4D phase-contrast magnetic resonance imaging (MRI) data were acquired. Geometries of the thoracic aorta with CoAs were reconstructed using ZIB-Amira software. X-ray angiograms were used to evaluate the post-treatment geometry. Computational fluid dynamics models in three patients were created to simulate pre- and post-treatment situations using the FLUENT program. The aim of the study was to investigate the impact of the inlet velocity profile (plug vs. MRI-based) with a focus on the peak systole pressure gradient and wall shear stress (WSS). Results show that helical flow at the aorta inlet can significantly affect the assessment of pressure drop and WSS. Simplified plug inlet velocity profiles significantly (p < 0.05) overestimate the pressure drop in pre- and post-treatment geometries and significantly (p < 0.05) underestimate surface-averaged WSS. We conclude that the use of the physiologically correct but time-expensive 4D MRI-based in vivo velocity profile in CFD studies may be an important step towards a patient-specific analysis of CoA hemodynamics.

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Abbreviations

CoA:

Aortic coarctation

MRI:

Magnetic resonance imaging

PC-MRI:

Phase contrast MRI

WH:

Whole heart

BA:

Brachiocephalic artery

LCCA:

Left common carotid artery

LSA:

Left subclavian artery

CFD:

Computational fluid dynamics

SD:

Degree of stenosis

H:

Helicity

WSS:

Wall shear stress

1D:

One-dimensional

3D:

Three-dimensional

4D:

Four-dimensional

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Acknowledgments

This study was supported by the German Research Foundation (DFG).

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Authors and Affiliations

  1. Biofluid Mechanics Laboratory, Charité-Universitätsmedizin Berlin, Thielallee 73, 14195, Berlin, Germany

    L. Goubergrits, R. Mevert, P. Yevtushenko, J. Schaller & U. Kertzscher

  2. Modeling and Simulation Group, Fraunhofer MEVIS, Bremen, Germany

    S. Meier

  3. Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum, Berlin, Germany

    S. Schubert & E. Riesenkampff

  4. Non-Invasive Cardiac Imaging in Congenital Heart Disease Unit, Charité-Universitätsmedizin, Berlin, Germany

    T. Kuehne

  5. German Heart Institute, Berlin, Germany

    T. Kuehne

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  1. L. Goubergrits
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Correspondence to L. Goubergrits.

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Associate Editor Robert Nerem oversaw the review of this article.

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Goubergrits, L., Mevert, R., Yevtushenko, P. et al. The Impact of MRI-based Inflow for the Hemodynamic Evaluation of Aortic Coarctation. Ann Biomed Eng 41, 2575–2587 (2013). https://doi.org/10.1007/s10439-013-0879-2

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  • DOI: https://doi.org/10.1007/s10439-013-0879-2

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