Key result
Increasing aortic coarctation severity from 25% to 75% increased maximal blood velocity up to 1.95 m/s and reduced the HOLMES index by up to 75% immediately downstream of the narrowing.
Why the study?
There is a lack of clear management approaches based on coarctation of the aorta severity, and wall shear stress cannot be measured clinically.
Does the severity of aortic coarctation affect wall shear stress indices and pressure gradients in computational fluid-solid interaction models?
Does the severity of aortic coarctation affect wall shear stress indices and pressure gradients in computational fluid-solid interaction models?
Fluid-solid interaction simulations demonstrate that increasing severity of aortic coarctation significantly worsens wall shear stress indices, highlighting the potential of computational hemodynamics to guide patient-specific interventions.
May guide aortic flow modeling; leaves open clinical validation of HOLMES index in coarctation.
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.
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Rafiei et al. (2021) studied Coarctation of the aorta (n=3). Coarctation severity (75% vs 50% vs 25% narrowing) vs. Milder coarctation degrees was evaluated on Wall shear stress (WSS) indices, pressure gradient, and HOLMES index. Increasing aortic coarctation severity from 25% to 75% increased maximal blood velocity up to 1.95 m/s and reduced the HOLMES index by up to 75% immediately downstream of the narrowing.
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