Date of Award
Spring 2024
Document Type
Thesis
Degree Name
Master of Science (MS)
Department
Biomedical Engineering
First Advisor
John LaDisa
Abstract
Coarctation of the aorta (CoA) is a congenital cardiovascular defect characterized by narrowing of the proximal descending thoracic aorta and is often associated with long-term hypertension (HTN) even after treatment. The current threshold for intervention in CoA patients, defined by a >20 mmHg peak-to-peak blood pressure gradient (BPGpp), does not effectively prevent HTN post-treatment and depends on the approached used for BPGpp measurement. To address this, the objective of this study was to develop the Coarctation of the Aorta App to Combat Hypertension (CoACH), which integrates a new index, the continuous flow pressure gradient (CFPG). The CFPG provides a more accurate representation of BPG severity compared to the current criterion and therefore may ultimately be used in proposing new thresholds to limit the likelihood of HTN after treatment of CoA. Our study focused on developing the CoACH application to be applicable for use on devices with access to a web browser. The CoACH application, developed using Python programming language, allows users to calculate the CFPG value of CoA patients and receives interpretation that correlates the calculated CFPG value with an arm-leg BPG value. Furthermore, a moderated qualitative usability test was conducted with 10 participants, including pediatric cardiologists and sonographers. Feedback from participants highlighted the user-friendly nature of the application and its potential to refine treatment guidelines, with a 4.3 out of 5 rating for the participant’s satisfaction. The integration of CFPG into CoACH, coupled with its implementation in TomTec, an echo lab software already familiar to sonographers, is expected to facilitate widespread clinical adoption of the CFPG. Overall, CoACH represents a substantial advancement in CoA assessment, challenging the current intervention threshold and paving the way for improved treatment strategies. The application's implementation holds promise in preventing recurrent hypertension post-intervention, ultimately enhancing outcomes for CoA patients.