Computational fluid dynamics simulation to evaluate aortic coarctation gradient with contrast-enhanced CT

Antonino Rinaudo, Giuseppe D'Ancona, Roberto Baglini, Andrea Amaducci, Fabrizio Follis, Michele Pilato, Salvatore Pasta

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Coarctation of aorta (CoA) is a narrowing of the aorta leading to a pressure gradient (ΔP) across the coarctation, increased afterload and reduced peripheral perfusion pressures. Indication to invasive treatment is based on values of maximal (systolic) trans-coarctation ΔP. A computational fluid dynamic (CFD) approach is herein presented for the non-invasive haemodynamic assessment of ΔP across CoA. Patient-specific CFD simulations were created from contrast-enhanced computed tomography (CT) and appropriate flow boundary conditions. Computed ΔP was validated with invasive intravascular trans-CoA pressure measurements. Haemodynamic indices, including pressure loss coefficient (PLc), time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI), were also quantified. CFD-estimated ΔP values were comparable to the invasive ones. Moreover, the aorta proximal to CoA was exposed to altered TAWSS and OSI suggesting hypertension. PLc was found as a further geometric marker of CoA severity. Finally, CFD-estimated ΔP confirmed a significant reduction after percutaneous balloon dilatation and stenting of the CoA in one patient (e.g. from ΔP∼52 mmHg to ΔP∼3 mmHg). The validation of the ΔP computations with catheterisation measurements suggests that CFD simulation, based on CT-derived anatomical data, is a useful tool to readily quantify CoA severity.

Original languageEnglish
Pages (from-to)1066-1071
Number of pages6
JournalComputer Methods in Biomechanics and Biomedical Engineering
Volume18
Issue number10
DOIs
Publication statusPublished - Jul 27 2015

Fingerprint

Tomography
Computational fluid dynamics
Computer simulation
Hemodynamics
Shear stress
Balloons
Pressure measurement
Pressure gradient
Boundary conditions

Keywords

  • coarctation of aorta
  • computational fluid dynamics
  • contrast-enhanced computed tomography
  • pressure gradient

ASJC Scopus subject areas

  • Bioengineering
  • Biomedical Engineering
  • Computer Science Applications
  • Human-Computer Interaction

Cite this

Computational fluid dynamics simulation to evaluate aortic coarctation gradient with contrast-enhanced CT. / Rinaudo, Antonino; D'Ancona, Giuseppe; Baglini, Roberto; Amaducci, Andrea; Follis, Fabrizio; Pilato, Michele; Pasta, Salvatore.

In: Computer Methods in Biomechanics and Biomedical Engineering, Vol. 18, No. 10, 27.07.2015, p. 1066-1071.

Research output: Contribution to journalArticle

@article{eea2fef765934a9392a75c0bd1797671,
title = "Computational fluid dynamics simulation to evaluate aortic coarctation gradient with contrast-enhanced CT",
abstract = "Coarctation of aorta (CoA) is a narrowing of the aorta leading to a pressure gradient (ΔP) across the coarctation, increased afterload and reduced peripheral perfusion pressures. Indication to invasive treatment is based on values of maximal (systolic) trans-coarctation ΔP. A computational fluid dynamic (CFD) approach is herein presented for the non-invasive haemodynamic assessment of ΔP across CoA. Patient-specific CFD simulations were created from contrast-enhanced computed tomography (CT) and appropriate flow boundary conditions. Computed ΔP was validated with invasive intravascular trans-CoA pressure measurements. Haemodynamic indices, including pressure loss coefficient (PLc), time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI), were also quantified. CFD-estimated ΔP values were comparable to the invasive ones. Moreover, the aorta proximal to CoA was exposed to altered TAWSS and OSI suggesting hypertension. PLc was found as a further geometric marker of CoA severity. Finally, CFD-estimated ΔP confirmed a significant reduction after percutaneous balloon dilatation and stenting of the CoA in one patient (e.g. from ΔP∼52 mmHg to ΔP∼3 mmHg). The validation of the ΔP computations with catheterisation measurements suggests that CFD simulation, based on CT-derived anatomical data, is a useful tool to readily quantify CoA severity.",
keywords = "coarctation of aorta, computational fluid dynamics, contrast-enhanced computed tomography, pressure gradient",
author = "Antonino Rinaudo and Giuseppe D'Ancona and Roberto Baglini and Andrea Amaducci and Fabrizio Follis and Michele Pilato and Salvatore Pasta",
year = "2015",
month = "7",
day = "27",
doi = "10.1080/10255842.2013.869321",
language = "English",
volume = "18",
pages = "1066--1071",
journal = "Computer Methods in Biomechanics and Biomedical Engineering",
issn = "1025-5842",
publisher = "Informa Healthcare",
number = "10",

}

TY - JOUR

T1 - Computational fluid dynamics simulation to evaluate aortic coarctation gradient with contrast-enhanced CT

AU - Rinaudo, Antonino

AU - D'Ancona, Giuseppe

AU - Baglini, Roberto

AU - Amaducci, Andrea

AU - Follis, Fabrizio

AU - Pilato, Michele

AU - Pasta, Salvatore

PY - 2015/7/27

Y1 - 2015/7/27

N2 - Coarctation of aorta (CoA) is a narrowing of the aorta leading to a pressure gradient (ΔP) across the coarctation, increased afterload and reduced peripheral perfusion pressures. Indication to invasive treatment is based on values of maximal (systolic) trans-coarctation ΔP. A computational fluid dynamic (CFD) approach is herein presented for the non-invasive haemodynamic assessment of ΔP across CoA. Patient-specific CFD simulations were created from contrast-enhanced computed tomography (CT) and appropriate flow boundary conditions. Computed ΔP was validated with invasive intravascular trans-CoA pressure measurements. Haemodynamic indices, including pressure loss coefficient (PLc), time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI), were also quantified. CFD-estimated ΔP values were comparable to the invasive ones. Moreover, the aorta proximal to CoA was exposed to altered TAWSS and OSI suggesting hypertension. PLc was found as a further geometric marker of CoA severity. Finally, CFD-estimated ΔP confirmed a significant reduction after percutaneous balloon dilatation and stenting of the CoA in one patient (e.g. from ΔP∼52 mmHg to ΔP∼3 mmHg). The validation of the ΔP computations with catheterisation measurements suggests that CFD simulation, based on CT-derived anatomical data, is a useful tool to readily quantify CoA severity.

AB - Coarctation of aorta (CoA) is a narrowing of the aorta leading to a pressure gradient (ΔP) across the coarctation, increased afterload and reduced peripheral perfusion pressures. Indication to invasive treatment is based on values of maximal (systolic) trans-coarctation ΔP. A computational fluid dynamic (CFD) approach is herein presented for the non-invasive haemodynamic assessment of ΔP across CoA. Patient-specific CFD simulations were created from contrast-enhanced computed tomography (CT) and appropriate flow boundary conditions. Computed ΔP was validated with invasive intravascular trans-CoA pressure measurements. Haemodynamic indices, including pressure loss coefficient (PLc), time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI), were also quantified. CFD-estimated ΔP values were comparable to the invasive ones. Moreover, the aorta proximal to CoA was exposed to altered TAWSS and OSI suggesting hypertension. PLc was found as a further geometric marker of CoA severity. Finally, CFD-estimated ΔP confirmed a significant reduction after percutaneous balloon dilatation and stenting of the CoA in one patient (e.g. from ΔP∼52 mmHg to ΔP∼3 mmHg). The validation of the ΔP computations with catheterisation measurements suggests that CFD simulation, based on CT-derived anatomical data, is a useful tool to readily quantify CoA severity.

KW - coarctation of aorta

KW - computational fluid dynamics

KW - contrast-enhanced computed tomography

KW - pressure gradient

UR - http://www.scopus.com/inward/record.url?scp=84918522578&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84918522578&partnerID=8YFLogxK

U2 - 10.1080/10255842.2013.869321

DO - 10.1080/10255842.2013.869321

M3 - Article

AN - SCOPUS:84918522578

VL - 18

SP - 1066

EP - 1071

JO - Computer Methods in Biomechanics and Biomedical Engineering

JF - Computer Methods in Biomechanics and Biomedical Engineering

SN - 1025-5842

IS - 10

ER -