Computational fluid dynamic simulations for determination of ventricular workload in aortic arch obstructions. J Thorac Cardiovasc Surg 2013 Feb;145(2):489-495.e1
Date
04/21/2012Pubmed ID
22516390DOI
10.1016/j.jtcvs.2012.03.051Scopus ID
2-s2.0-84872295895 (requires institutional sign-in at Scopus site) 18 CitationsAbstract
OBJECTIVE: The cardiac workload associated with various types of aortic obstruction was determined using computational fluid dynamic simulations.
METHODS: Computed tomography image data were collected from 4 patients with 4 distinct types of aortic arch obstructions and 4 controls. The categorization of arch hypoplasia corresponded to the "A, B, C" nomenclature of arch interruption; a type "D" was added to represent diffuse arch hypoplasia. Measurements of the vessel diameter were compared against the normal measurements to determine the degree of narrowing. Three-dimensional models were created for each patient, and additional models were created for type A and B hypoplasia to represent 25%, 50%, and 75% diameter narrowing. The boundary conditions for the computational simulations were chosen to achieve realistic flow and pressures in the control cases. The simulations were then repeated after changing the boundary conditions to represent a range of cardiac and vascular adaptations. The resulting cardiac workload was compared with the control cases.
RESULTS: Of the 4 patients investigated, 1 had aortic coarctation and 3 had aortic hypoplasia. The cardiac workload of the patients with 25% narrowing type A and B hypoplasia was not appreciably different from that of the control. When comparing the different arch obstructions, 75% type A, 50% type B, and 50% type D hypoplasia required a greater workload increase than 75% coarctation.
CONCLUSIONS: The present study has determined the hemodynamic significance of aortic arch obstruction using computational simulations to calculate the cardiac workload. These results suggest that all types of hypoplasia pose more of a workload challenge than coarctation with an equivalent degree of narrowing.
Author List
Coogan JS, Chan FP, Ladisa JF Jr, Taylor CA, Hanley FL, Feinstein JAAuthor
John F. LaDisa PhD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAorta, Thoracic
Aortic Coarctation
Aortography
Arterial Pressure
Cardiac Output
Case-Control Studies
Child
Computer Simulation
Constriction, Pathologic
Female
Heart Defects, Congenital
Hemodynamics
Humans
Hydrodynamics
Infant, Newborn
Male
Models, Cardiovascular
Numerical Analysis, Computer-Assisted
Tomography, X-Ray Computed
Ventricular Function, Left
Ventricular Pressure
