Abstract 2124: Modeling Blood Flow in Repaired Coarctation of the Aorta Using Computational Fluid Dynamics
Coarctation of the aorta accounts for 6% of congenital heart disease. Following adequate surgical repair, late morbidity includes abnormal vasomodulator response, hypertension and exercise-induced hypertension. Observational study links patterns of aortic arch remodeling (Gothic, Crenel, Normal) to incidence of late morbidity. Gothic has the highest late morbidity. Our aim was to evaluate flow in native and each remodeled aortic arch to correlate respective hemodynamic indices with incidence of late morbidity.
METHODS: 3D reconstructions of each remodeled arch were created from an anatomic stack of MR images. A structured mesh core with a boundary layer and vessel extensions was generated. Computational fluid dynamic (CFD) analysis was performed assuming peak flow conditions with a uniform velocity profile and unsteady laminar flow. Wall shear stress (WSS), pressure and velocity data were extracted.
RESULTS: The region of maximum WSS was located in the mid-transverse arch for the Native, Normal and Crenel. Peak WSS was located in the isthmus of the Gothic model (Figure 1⇓). Streamtraces are displayed to illustrate the variation in proximal vessel flow features between the models.
CONCLUSION: This work highlights for the first time the differences in hemodynamics between the different arch remodeling shapes. Of particular clinical relevance is the location of high WSS. The Gothic arch, linked with highest morbidity, had a unique location of peak WSS. These results suggest that it may be the location, rather than the magnitude of WSS that may exhibit the primary effect on clinical vascular dysfunction.