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Cardiovascular Engineering and Technology

, Volume 2, Issue 4, pp 288–295 | Cite as

Hemodynamic Modeling of Surgically Repaired Coarctation of the Aorta

  • Laura J. OlivieriEmail author
  • Diane A. de Zélicourt
  • Christopher M. Haggerty
  • Kanishka Ratnayaka
  • Russell R. Cross
  • Ajit P. Yoganathan
Article

Abstract

Late morbidity of surgically repaired coarctation of the aorta includes early cardiovascular and cerebrovascular disease, shortened life expectancy, abnormal vasomodulator response, hypertension and exercise-induced hypertension in the absence of recurrent coarctation. Observational studies have linked patterns of arch remodeling (Gothic, Crenel, and Romanesque) to late morbidity, with Gothic arches having the highest incidence. We evaluated flow in native and surgically repaired aortic arches to correlate respective hemodynamic indices with incidence of late morbidity. Three dimensional reconstructions of each remodeled arch were created from an anatomic stack of magnetic resonance (MR) images. A structured mesh core with a boundary layer was generated. Computational fluid dynamic (CFD) analysis was performed assuming peak flow conditions with a uniform velocity profile and unsteady turbulent flow. Wall shear stress (WSS), pressure and velocity data were extracted. The region of maximum WSS was located in the mid-transverse arch for the Crenel, Romanesque and Native arches. Peak WSS was located in the isthmus of the Gothic model. Variations in descending aorta flow patterns were also observed among the models. The location of peak WSS is a primary difference among the models tested, and may have clinical relevance. Specifically, the Gothic arch had a unique location of peak WSS with flow disorganization in the descending aorta. Our results suggest that varied patterns and locations of WSS resulting from abnormal arch remodeling may exhibit a primary effect on clinical vascular dysfunction.

Keywords

Aorta Coarctation Congenital heart disease Magnetic resonance imaging Wall shear stress 

Notes

Acknowledgments

This work is supported by National Institutes of Health/National Heart, Lung and Blood Institute Grant HL67622.

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Copyright information

© Biomedical Engineering Society 2011

Authors and Affiliations

  • Laura J. Olivieri
    • 1
    Email author
  • Diane A. de Zélicourt
    • 2
  • Christopher M. Haggerty
    • 2
  • Kanishka Ratnayaka
    • 1
  • Russell R. Cross
    • 1
  • Ajit P. Yoganathan
    • 2
  1. 1.Division of CardiologyChildren’s National Medical CenterWashingtonUSA
  2. 2.Wallace H. Coulter Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlantaUSA

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