Impact of extra-anatomical bypass on coarctation fluid dynamics using patient-specific lumped parameter and Lattice Boltzmann modeling

被引:14
|
作者
Sadeghi, Reza [1 ]
Tomka, Benjamin [1 ]
Khodaei, Seyedvahid [1 ]
Daeian, MohammadAli [1 ]
Gandhi, Krishna [1 ]
Garcia, Julio [2 ,3 ,4 ,5 ]
Keshavarz-Motamed, Zahra [1 ,6 ,7 ]
机构
[1] McMaster Univ, Dept Mech Engn, Hamilton, ON, Canada
[2] Libin Cardiovasc Inst Alberta, Stephenson Cardiac Imaging Ctr, Calgary, AB, Canada
[3] Univ Calgary, Dept Radiol, Calgary, AB, Canada
[4] Univ Calgary, Dept Cardiac Sci, Calgary, AB, Canada
[5] Alberta Childrens Prov Gen Hosp, Res Inst, Calgary, AB, Canada
[6] McMaster Univ, Sch Biomed Engn, Hamilton, ON, Canada
[7] McMaster Univ, Sch Computat Sci & Engn, Hamilton, ON, Canada
基金
加拿大自然科学与工程研究理事会;
关键词
WALL SHEAR-STRESS; IMPAIRED ELASTIC PROPERTIES; BICUSPID AORTIC-VALVE; ASCENDING AORTA; SURGICAL-MANAGEMENT; IN-VITRO; ENDOVASCULAR REPAIR; COMPLEX COARCTATION; CONSTRUCTAL DESIGN; FLOW PATTERNS;
D O I
10.1038/s41598-022-12894-y
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Accurate hemodynamic analysis is not only crucial for successful diagnosis of coarctation of the aorta (COA), but intervention decisions also rely on the hemodynamics assessment in both pre and post intervention states to minimize patient risks. Despite ongoing advances in surgical techniques for COA treatments, the impacts of extra-anatomic bypass grafting, a surgical technique to treat COA, on the aorta are not always benign. Our objective was to investigate the impact of bypass grafting on aortic hemodynamics. We investigated the impact of bypass grafting on aortic hemodynamics using a patient-specific computational-mechanics framework in three patients with COA who underwent bypass grafting. Our results describe that bypass grafting improved some hemodynamic metrics while worsened the others: (1) Doppler pressure gradient improved (decreased) in all patients; (2) Bypass graft did not reduce the flow rate substantially through the COA; (3) Systemic arterial compliance increased in patients #1 and 3 and didn't change (improve) in patient 3; (4) Hypertension got worse in all patients; (5) The flow velocity magnitude improved (reduced) in patient 2 and 3 but did not improve significantly in patient 1; (6) There were elevated velocity magnitude, persistence of vortical flow structure, elevated turbulence characteristics, and elevated wall shear stress at the bypass graft junctions in all patients. We concluded that bypass graft may lead to pseudoaneurysm formation and potential aortic rupture as well as intimal hyperplasia due to the persistent abnormal and irregular aortic hemodynamics in some patients. Moreover, post-intervention, exposures of endothelial cells to high shear stress may lead to arterial remodeling, aneurysm, and rupture.
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页数:24
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