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Effect of coarctation of the aorta and bicuspid aortic valve on flow dynamics and turbulence in the aorta using particle image velocimetry

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Abstract

Blood flow in the aorta has been of particular interest from both fluid dynamics and physiology perspectives. Coarctation of the aorta (COA) is a congenital heart disease corresponding to a severe narrowing in the aortic arch. Up to 85 % of patients with COA have a pathological aortic valve, leading to a narrowing at the valve level. The aim of the present work was to advance the state of understanding of flow through a COA to investigate how narrowing in the aorta (COA) affects the characteristics of the velocity field and, in particular, turbulence development. For this purpose, particle image velocimetry measurements were conducted at physiological flow and pressure conditions, with three different aorta configurations: (1) normal case: normal aorta + normal aortic valve; (2) isolated COA: COA (with 75 % reduction in aortic cross-sectional area) + normal aortic valve and (3) complex COA: COA (with 75 % reduction in aortic cross-sectional area) + pathological aortic valve. Viscous shear stress (VSS), representing the physical shear stress, Reynolds shear stress (RSS), representing the turbulent shear stress, and turbulent kinetic energy (TKE), representing the intensity of fluctuations in the fluid flow environment, were calculated for all cases. Results show that, compared with a healthy aorta, the instantaneous velocity streamlines and vortices were deeply changed in the presence of the COA. The normal aorta did not display any regions of elevated VSS, RSS and TKE at any moment of the cardiac cycle. The magnitudes of these parameters were elevated for both isolated COA and complex COA, with their maximum values mainly being located inside the eccentric jet downstream of the COA. However, the presence of a pathologic aortic valve, in complex COA, amplifies VSS (e.g., average absolute peak value in the entire aorta for a total flow of 5 L/min: complex COA: = 36 N/m2; isolated COA = 19 N/m2), RSS (e.g., average peak value in the entire aorta for a total flow of 5 L/min: complex COA: = 84.6 N/m2; isolated COA = 44 N/m2) and TKE (e.g., average peak value in the entire aorta for a total flow of 5 L/min: complex COA: = 215 N/m2; isolated COA = 100 N/m2). This demonstrates that the pathological aortic valve strongly interacts with the COA. Findings of this study indicate that the presence of both a COA and a pathological aortic valve significantly alters hemodynamics in the aorta and thus might contribute to the progression of the disease in this region. This study can partially explain the complications associated in patients with COA, in the presence of a pathological aortic valve and the consequent adverse outcome post-surgery.

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Authors and Affiliations

  1. Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Pavilion J.A. de Sève, 2099 Alexandre de Sève, Montréal, QC, H2L 2W5, Canada

    Zahra Keshavarz-Motamed & Guy Cloutier

  2. Laboratory of Cardiovascular Fluid Dynamics, Department of Mechanical and Industrial Engineering, Concordia University, 1455 de Maisonneuve Blvd W, Montreal, QC, H3G 1M8, Canada

    Zahra Keshavarz-Motamed, Emmanuel Gaillard, Giuseppe Di Labbio & Lyes Kadem

  3. Department of Radiology, Northwestern University, Chicago, IL, USA

    Julio Garcia

  4. Québec Heart and Lung Institute, Laval University, Quebec, QC, Canada

    Julio Garcia

  5. Biomedical Engineering Department, McGill University, Montreal, QC, Canada

    Nima Maftoon

  6. Biomedical Engineering Department, University of Montreal, Montreal, QC, Canada

    Guy Cloutier

  7. Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, Canada

    Guy Cloutier

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  1. Zahra Keshavarz-Motamed
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Correspondence to Zahra Keshavarz-Motamed.

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Keshavarz-Motamed, Z., Garcia, J., Gaillard, E. et al. Effect of coarctation of the aorta and bicuspid aortic valve on flow dynamics and turbulence in the aorta using particle image velocimetry. Exp Fluids 55, 1696 (2014). https://doi.org/10.1007/s00348-014-1696-6

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  • DOI: https://doi.org/10.1007/s00348-014-1696-6

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