Title

Computational Fluid Dynamic Simulations for Determination of Ventricular Workload in Aortic Arch Obstructions

Document Type

Article

Language

eng

Format of Original

7 p.

Publication Date

2-2013

Publisher

Elsevier

Source Publication

The Journal of Thoracic and Cardiovascular Surgery

Source ISSN

0022-5223

Original Item ID

doi: 10.1016/j.jtcvs.2012.03.051

Abstract

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.

Comments

The Journal of Thoracic and Cardiovascular Surgery, Vol. 145, No. 2 (February 2013): 489-495. DOI.