title: Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study.
abstract: Even after successful treatment of aortic coarctation, a high risk of cardiovascular morbidity and mortality remains. Uncertainty exists on the factors contributing to this increased risk among which are the presence of (1) a residual narrowing leading to an additional resistance and (2) a less distensible zone disturbing the buffer function of the aorta. As the many interfering factors and adaptive physiological mechanisms present in vivo prohibit the study of the isolated impact of these individual factors, a numerical fluid-structure interaction model is developed to predict central hemodynamics in coarctation treatment. The overall impact of a stiffening on the hemodynamics is limited, with a small increase in systolic pressure (up to 8 mmHg) proximal to the stiffening which is amplified with increasing stiffening and length. A residual narrowing, on the other hand, affects the hemodynamics significantly. For a short segment (10 mm), the combination of a stiffening and narrowing (coarctation index 0.5) causes an increase in systolic pressure of 58 mmHg, with 31 mmHg due to narrowing and an additional 27 mmHg due to stiffening. For a longer segment (25 mm), an increase in systolic pressure of 50 mmHg is found, of which only 9 mmHg is due to stiffening.
authors.affiliation: IBiTech-bioMMeda, iMinds Medical IT, Faculty of Engineering and Architecture, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. liesbeth.taelman@ugent.be.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Taelman
authors.affiliation: Department of Flow, Heat and Combustion Mechanics, Faculty of Engineering and Architecture, Ghent University, Sint-Pietersnieuwstraat 41, 9000, Ghent, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Bols
authors.affiliation: Department of Flow, Heat and Combustion Mechanics, Faculty of Engineering and Architecture, Ghent University, Sint-Pietersnieuwstraat 41, 9000, Ghent, Belgium.
authors.forename: Joris
authors.initials: J
authors.lastname: Degroote
authors.affiliation: Centre for Cardiovascular MR, UCL Institute of Child Health, London Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.
authors.forename: Vivek
authors.initials: V
authors.lastname: Muthurangu
authors.affiliation: Paediatric Cardiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Joseph
authors.initials: J
authors.lastname: Panzer
authors.affiliation: Department of Flow, Heat and Combustion Mechanics, Faculty of Engineering and Architecture, Ghent University, Sint-Pietersnieuwstraat 41, 9000, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Vierendeels
authors.affiliation: IBiTech-bioMMeda, iMinds Medical IT, Faculty of Engineering and Architecture, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Segers
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D011312:Pressure; D059289:Vascular Stiffness
keywords: End-to-end anastomosis; Fluid–structure interaction; Image-based modeling; Stent