The effect of coarctation degrees on wall shear stress indices

Abstract

Coarctation of the aorta (CoA) is a congenital tightening of the proximal descending aorta. Flow quantification can be immensely valuable for an early and accurate diagnosis. However, there is a lack of appropriate diagnostic approaches for a variety of cardiovascular diseases, such as CoA. An accurate understanding of the disease depends on measurements of the global haemodynamics (criteria for heart function) and also the local haemodynamics (detailed data on the dynamics of blood flow). Playing a significant role in clinical processes, wall shear stress (WSS) cannot be measured clinically; thus, computation tools are needed to give an insight into this crucial haemodynamic parameter. In the present study, in order to enable the progress of non-invasive approaches that quantify global and local haemodynamics for different CoA severities, innovative computational blueprint simulations that include fluid–solid interaction models are developed. Since there is no clear approach for managing the CoA regarding its severity, this study proposes the use of WSS indices and pressure gradient to better establish a framework for treatment procedures in CoA patients with different severities. This provides a platform for improving CoA therapy on a patient-specific level, in which physicians can perform treatment methods based on WSS indices on top of using a mere experience. Results show how severe CoA affects the aorta in comparison to the milder cases, which can give the medical community valuable information before and after any intervention.

The effect of beta-blockers on hemodynamic parameters in patient-specific blood flow simulations of type-B aortic dissection: a virtual study

“…The variation of OSI in moderate and regular models turns into more stable, suggesting a better mechanical condition for the aortic endothelial cells. As reported by previous research 6 , 29 , 57 , an invaluable part of WSS indicators is that if an area exposes to a high OSI and low TAWSS, there is a high risk of rupture, calcification, or wall thickening. High OSI values in distal FL with low TAWSS (around DA) can potentially lead to high-risk complications.…”

“…In recent years, several studies have reported the importance of personalised computational fluid dynamics (CFD) methods along with imaging techniques to develop diagnosis and controlling approaches of aortic disease, in order to customize patient-specific treatment outcomes 23 – 29 . Some studies have shown the importance of the combination of particle image velocimetry and CFD simulations in type-B AD in pre-procedural planning, clinical decision support, and CFD models validation 30 , 31 .…”

A coupled atrioventricular-aortic setup for in-vitro hemodynamic study of the systemic circulation: Design, Fabrication, and Physiological relevancy

“…Future work includes developing a large in-vitro database using our setup for resolving issues related to usually small-sized in-vivo databases in order to facilitate specific hemodynamics-based big-data studies [43–45]. In addition, the setup can be used to simulate more complicated diseases, e.g., myocardial infarction, hemorrhagic shock, or aortic coarctation, where several physiological responses need to be simulated (i.e., changing our setup based on the main pathophysiology/abnormalities of the corresponding disease condition) [30, 46, 47].…”

A coupled atrioventricular-aortic setup for in-vitro hemodynamic study of the systemic circulation: Design, fabrication, and physiological relevancy

“…Other future works include developing a large in-vitro database using our setup for resolving issues related to usually small-sized in-vivo databases to facilitate specific hemodynamicsbased big-data studies [58][59][60][61][62] (more details were provided in Section 4.). In addition, as mentioned in Section 4, the setup can be used to simulate more complicated diseases, e.g., myocardial infarction, hemorrhagic shock, or aortic coarctation/dissection, where several physiological responses need to be simulated (i.e., changing our setup based on the main pathophysiology/abnormalities of the corresponding disease condition) [32,63].…”