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 journalArticlepeer-review

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

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

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