Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study

作     者：Taelman, Liesbeth Bols, Joris Degroote, Joris Muthurangu, Vivek Panzer, Joseph Vierendeels, Jan Segers, Patrick 

作者机构：Univ Ghent Fac Engn & Architecture IBiTech bioMMeda iMinds Med IT B-9000 Ghent Belgium Univ Ghent Fac Engn & Architecture Dept Flow Heat & Combust Mech Sint Pietersnieuwstr 41 B-9000 Ghent Belgium London Great Ormond St Hosp Children UCL Inst Child Hlth Ctr Cardiovasc MR Great Ormond St London WC1N 3JH England Ghent Univ Hosp Paediat Cardiol De Pintelaan 185 B-9000 Ghent Belgium 

出 版 物：《MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING》 (医学和生物工程与计算)

年 卷 期：2016年第54卷第2-3期

页      面：497-510页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 0710[理学-生物学] 1001[医学-基础医学(可授医学、理学学位)] 0812[工学-计算机科学与技术（可授工学、理学学位）] 10[医学] 

基　　金：Research Foundation-Flanders (FWO-Vlaanderen) [3G008509] 

主　　题：Fluid-structure interaction Stent End-toend anastomosis Image-based modeling 

摘      要：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.