Key result
4-dimensional flow cardiac magnetic resonance identified increased wall shear stress in the conduit's acute angle and distal anastomosis following extracardiac bypass for aortic coarctation.
Why the study?
Does 4-dimensional flow cardiac magnetic resonance identify increased wall shear stress in patients with extracardiac bypass for aortic coarctation?
Case Report (n=1)
Does 4-dimensional flow cardiac magnetic resonance identify increased wall shear stress in patients with extracardiac bypass for aortic coarctation?
4-dimensional flow cardiac magnetic resonance can identify increased wall shear stress in extracardiac bypass conduits, potentially aiding in the risk stratification of adult congenital heart disease patients for future vascular complications.
4D-flow CMR may detect conduit shear stress abnormalities post-coarctation bypass; leaves open its prognostic value in adult congenital heart disease.
This report describes a case of a young lady who, following extracardiac bypass between ascending and descending aorta for severe aortic coarctation, underwent 4-dimensional flow cardiac magnetic resonance, a technique that, by 3-dimensional flow assessment over time (4-dimensional), allows not only quantification of flows but also wall shear stress. In this case, increased wall shear stress was observed in the conduit's acute angle (kinking) as well as at the distal anastomosis level. The authors postulate that increased wall shear stress could help identify and risk stratify adult congenital heart disease who could develop vascular complications in the future. (Level of Difficulty: Intermediate.)
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Ait-Alì et al. (2019) conducted a case report in Severe aortic coarctation (n=1). 4-dimensional flow cardiac magnetic resonance was evaluated on Wall shear stress and flow quantification. 4-dimensional flow cardiac magnetic resonance identified increased wall shear stress in the conduit's acute angle and distal anastomosis following extracardiac bypass for aortic coarctation.
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