Skip to main content
Top
Published in: Medical & Biological Engineering & Computing 2-3/2016

01-03-2016 | Original Article

Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study

Authors: Liesbeth Taelman, Joris Bols, Joris Degroote, Vivek Muthurangu, Joseph Panzer, Jan Vierendeels, Patrick Segers

Published in: Medical & Biological Engineering & Computing | Issue 2-3/2016

Log in

Activate our intelligent search to find suitable subject content or patents.

search-config
loading …

Abstract

Even after successful treatment of aortic coarctation, a high risk of cardiovascular morbidity and mortality remains. Uncertainty exists on the factors contributing to this increased risk among which are the presence of (1) a residual narrowing leading to an additional resistance and (2) a less distensible zone disturbing the buffer function of the aorta. As the many interfering factors and adaptive physiological mechanisms present in vivo prohibit the study of the isolated impact of these individual factors, a numerical fluid–structure interaction model is developed to predict central hemodynamics in coarctation treatment. The overall impact of a stiffening on the hemodynamics is limited, with a small increase in systolic pressure (up to 8 mmHg) proximal to the stiffening which is amplified with increasing stiffening and length. A residual narrowing, on the other hand, affects the hemodynamics significantly. For a short segment (10 mm), the combination of a stiffening and narrowing (coarctation index 0.5) causes an increase in systolic pressure of 58 mmHg, with 31 mmHg due to narrowing and an additional 27 mmHg due to stiffening. For a longer segment (25 mm), an increase in systolic pressure of 50 mmHg is found, of which only 9 mmHg is due to stiffening.

Dont have a licence yet? Then find out more about our products and how to get one now:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Technik"

Online-Abonnement

Mit Springer Professional "Technik" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 390 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Maschinenbau + Werkstoffe




 

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Appendix
Available only for authorised users
Literature
1.
go back to reference Aspden A, Nikiforakis N, Dalziel S, Bell J (2009) Analysis of implicit LES methods. Commun Appl Math Comput Sci 3:103–126CrossRef Aspden A, Nikiforakis N, Dalziel S, Bell J (2009) Analysis of implicit LES methods. Commun Appl Math Comput Sci 3:103–126CrossRef
2.
go back to reference Bols J, De Santis G, Degroote J, Verhegghe B, Segers P, Vierendeels J (2013) Automated hexahedral mesh generation in a complex vascular tree: the extended treemesh method. In: ASME 2013 summer bioengineering conference. American Society of Mechanical Engineers, pp V01AT13A019–V001AT013A019 Bols J, De Santis G, Degroote J, Verhegghe B, Segers P, Vierendeels J (2013) Automated hexahedral mesh generation in a complex vascular tree: the extended treemesh method. In: ASME 2013 summer bioengineering conference. American Society of Mechanical Engineers, pp V01AT13A019–V001AT013A019
4.
go back to reference Carvalho JS, Redington AN, Shinebourne EA, Rigby ML, Gibson D (1990) Continuous wave doppler echocardiography and coarctation of the aorta—gradients and flow patterns in the assessment of severity. Br Heart J 64:133–137CrossRefPubMedPubMedCentral Carvalho JS, Redington AN, Shinebourne EA, Rigby ML, Gibson D (1990) Continuous wave doppler echocardiography and coarctation of the aorta—gradients and flow patterns in the assessment of severity. Br Heart J 64:133–137CrossRefPubMedPubMedCentral
6.
go back to reference Charonko JJ, Ragab SA, Vlachos PP (2009) A scaling parameter for predicting pressure wave reflection in stented arteries. J Med Device Trans Asme. doi:10.1115/1.3089140 Charonko JJ, Ragab SA, Vlachos PP (2009) A scaling parameter for predicting pressure wave reflection in stented arteries. J Med Device Trans Asme. doi:10.​1115/​1.​3089140
8.
go back to reference Cohen M, Fuster V, Steele PM, Driscoll D, McGoon DC (1989) Coarctation of the aorta—long-term follow-up and prediction of outcome after surgical-correction. Circulation 80:840–845CrossRefPubMed Cohen M, Fuster V, Steele PM, Driscoll D, McGoon DC (1989) Coarctation of the aorta—long-term follow-up and prediction of outcome after surgical-correction. Circulation 80:840–845CrossRefPubMed
9.
10.
go back to reference de Divitiis M, Rubba P, Calabro R (2005) Arterial hypertension and cardiovascular prognosis after successful repair of aortic coarctation: a clinical model for the study of vascular function. Nutr Metabol Cardiovasc Dis 15:382–394. doi:10.1016/j.numecd.2005.08.002 CrossRef de Divitiis M, Rubba P, Calabro R (2005) Arterial hypertension and cardiovascular prognosis after successful repair of aortic coarctation: a clinical model for the study of vascular function. Nutr Metabol Cardiovasc Dis 15:382–394. doi:10.​1016/​j.​numecd.​2005.​08.​002 CrossRef
11.
go back to reference De Santis G, Mortier P, De Beule M, Segers P, Verdonck P, Verhegghe B (2010) Patient-specific computational fluid dynamics: structured mesh generation from coronary angiography. Med Biol Eng Comput 48:371–380. doi:10.1007/s11517-010-0583-4 CrossRefPubMed De Santis G, Mortier P, De Beule M, Segers P, Verdonck P, Verhegghe B (2010) Patient-specific computational fluid dynamics: structured mesh generation from coronary angiography. Med Biol Eng Comput 48:371–380. doi:10.​1007/​s11517-010-0583-4 CrossRefPubMed
13.
go back to reference Ebeid M (2003) Balloon expandable stents for coarctation of the aorta: review of current status and technical considerations. Image Paediatr Cardiol 5:25–41 Ebeid M (2003) Balloon expandable stents for coarctation of the aorta: review of current status and technical considerations. Image Paediatr Cardiol 5:25–41
15.
go back to reference Formaggia L, Nobile F, Quarteroni A (2002) A one dimensional model for blood flow: application to vascular prosthesis. In: Ciarlet PG, Miyoshi T (eds) Mathematical modeling and numerical simulation in continuum mechanics, vol 19. Lecture notes in computational science and engineering, pp 137–153 Formaggia L, Nobile F, Quarteroni A (2002) A one dimensional model for blood flow: application to vascular prosthesis. In: Ciarlet PG, Miyoshi T (eds) Mathematical modeling and numerical simulation in continuum mechanics, vol 19. Lecture notes in computational science and engineering, pp 137–153
16.
go back to reference Giddens DP, Mabon RF, Cassanova RA (1976) Measurements of disordered flows distal to subtotal vascular stenoses in thoracic aortas of dogs. Circ Res 39:112–119CrossRefPubMed Giddens DP, Mabon RF, Cassanova RA (1976) Measurements of disordered flows distal to subtotal vascular stenoses in thoracic aortas of dogs. Circ Res 39:112–119CrossRefPubMed
19.
go back to reference Johnston TA, Grifka RG, Jones TK (2004) Endovascular stents for treatment of coarctation of the aorta: acute results and follow-up experience. Catheter Cardiovasc Interv 62:499–505. doi:10.1002/ccd.20071 CrossRefPubMed Johnston TA, Grifka RG, Jones TK (2004) Endovascular stents for treatment of coarctation of the aorta: acute results and follow-up experience. Catheter Cardiovasc Interv 62:499–505. doi:10.​1002/​ccd.​20071 CrossRefPubMed
21.
go back to reference Kim HJ, Vignon-Clementel IE, Figueroa CA, LaDisa JF, Jansen KE, Feinstein JA, Taylor CA (2009) On coupling a lumped parameter heart model and a three-dimensional finite element aorta model. Ann Biomed Eng 37:2153–2169. doi:10.1007/s10439-009-9760-8 CrossRefPubMed Kim HJ, Vignon-Clementel IE, Figueroa CA, LaDisa JF, Jansen KE, Feinstein JA, Taylor CA (2009) On coupling a lumped parameter heart model and a three-dimensional finite element aorta model. Ann Biomed Eng 37:2153–2169. doi:10.​1007/​s10439-009-9760-8 CrossRefPubMed
23.
go back to reference LaDisa JF Jr, Figueroa CA, Vignon-Clementel IE, Kim HJ, Xiao N, Ellwein LM, Chan FP, Feinstein JA, Taylor CA (2011) Computational simulations for aortic coarctation: representative results from a sampling of patients. J Biomech Eng Trans Asme. doi:10.1115/1.4004996 LaDisa JF Jr, Figueroa CA, Vignon-Clementel IE, Kim HJ, Xiao N, Ellwein LM, Chan FP, Feinstein JA, Taylor CA (2011) Computational simulations for aortic coarctation: representative results from a sampling of patients. J Biomech Eng Trans Asme. doi:10.​1115/​1.​4004996
26.
go back to reference Marom G, Kim H-S, Rosenfeld M, Raanani E, Haj-Ali R (2013) Fully coupled fluid–structure interaction model of congenital bicuspid aortic valves: effect of asymmetry on hemodynamics. Med Biol Eng Comput 51:839–848. doi:10.1007/s11517-013-1055-4 CrossRefPubMed Marom G, Kim H-S, Rosenfeld M, Raanani E, Haj-Ali R (2013) Fully coupled fluid–structure interaction model of congenital bicuspid aortic valves: effect of asymmetry on hemodynamics. Med Biol Eng Comput 51:839–848. doi:10.​1007/​s11517-013-1055-4 CrossRefPubMed
28.
go back to reference Menon A, Wendell DC, Wang H, Eddinger TJ, Toth JM, Dholakia RJ, Larsen PM, Jensen ES, LaDisa JF Jr (2012) A coupled experimental and computational approach to quantify deleterious hemodynamics, vascular alterations, and mechanisms of long-term morbidity in response to aortic coarctation. J Pharmacol Toxicol Methods 65:18–28. doi:10.1016/j.vascn.2011.10.003 CrossRefPubMedPubMedCentral Menon A, Wendell DC, Wang H, Eddinger TJ, Toth JM, Dholakia RJ, Larsen PM, Jensen ES, LaDisa JF Jr (2012) A coupled experimental and computational approach to quantify deleterious hemodynamics, vascular alterations, and mechanisms of long-term morbidity in response to aortic coarctation. J Pharmacol Toxicol Methods 65:18–28. doi:10.​1016/​j.​vascn.​2011.​10.​003 CrossRefPubMedPubMedCentral
29.
32.
go back to reference Orourke MF, Cartmill TB (1971) Influence of aortic coarctation on pulsatile hemodynamics in proximal aorta. Circulation 44:281CrossRef Orourke MF, Cartmill TB (1971) Influence of aortic coarctation on pulsatile hemodynamics in proximal aorta. Circulation 44:281CrossRef
33.
go back to reference Pedersen TA (2012) Late morbidity after repair of aortic coarctation. Dan Med J 59:B4436PubMed Pedersen TA (2012) Late morbidity after repair of aortic coarctation. Dan Med J 59:B4436PubMed
35.
go back to reference Prendergast PJ, Lally C, Daly S, Reid AJ, Lee TC, Quinn D, Dolan F (2003) Analysis of prolapse in cardiovascular stents: a constitutive equation for vascular tissue and finite-element modelling. J Biomech Eng Trans Asme 125:692–699. doi:10.1115/1.1613674 CrossRef Prendergast PJ, Lally C, Daly S, Reid AJ, Lee TC, Quinn D, Dolan F (2003) Analysis of prolapse in cardiovascular stents: a constitutive equation for vascular tissue and finite-element modelling. J Biomech Eng Trans Asme 125:692–699. doi:10.​1115/​1.​1613674 CrossRef
37.
go back to reference Stergiopulos N, Segers P, Westerhof N (1999) Use of pulse pressure method for estimating total arterial compliance in vivo. Am J Physiol Heart Circ Physiol 276:H424–H428 Stergiopulos N, Segers P, Westerhof N (1999) Use of pulse pressure method for estimating total arterial compliance in vivo. Am J Physiol Heart Circ Physiol 276:H424–H428
38.
go back to reference Stewart AB, Ahmed R, Travill CM, Newman CGH (1993) Coarctation of the aorta life and health 20–44 years after surgical repair. Br Heart J 69:65–70CrossRefPubMedPubMedCentral Stewart AB, Ahmed R, Travill CM, Newman CGH (1993) Coarctation of the aorta life and health 20–44 years after surgical repair. Br Heart J 69:65–70CrossRefPubMedPubMedCentral
39.
go back to reference Taelman L, Degroote J, Swillens A, Vierendeels J, Segers P (2014) Fluid–structure interaction simulation of pulse propagation in arteries: numerical pitfalls and hemodynamic impact of a local stiffening. Int J Eng Sci 77:1–13. doi:10.1016/j.ijengsci.2013.12.002 CrossRef Taelman L, Degroote J, Swillens A, Vierendeels J, Segers P (2014) Fluid–structure interaction simulation of pulse propagation in arteries: numerical pitfalls and hemodynamic impact of a local stiffening. Int J Eng Sci 77:1–13. doi:10.​1016/​j.​ijengsci.​2013.​12.​002 CrossRef
40.
go back to reference Valverde I, Staicu C, Grotenhuis H, Marzo A, Rhode K, Shi Y, Brown A, Tzifa A, Hussain T, Greil G, Lawford P, Razavi R, Hose R, Beerbaum P (2011) Predicting hemodynamics in native and residual coarctation: preliminary results of a rigid-wall computational-fluid-dynamics model (RW-CFD) validated against clinically invasive pressure measures at rest and during pharmacological stress. J Cardiovasc Magn Reson 13:1–4. doi:10.1186/1532-429X-13-S1-P49 CrossRef Valverde I, Staicu C, Grotenhuis H, Marzo A, Rhode K, Shi Y, Brown A, Tzifa A, Hussain T, Greil G, Lawford P, Razavi R, Hose R, Beerbaum P (2011) Predicting hemodynamics in native and residual coarctation: preliminary results of a rigid-wall computational-fluid-dynamics model (RW-CFD) validated against clinically invasive pressure measures at rest and during pharmacological stress. J Cardiovasc Magn Reson 13:1–4. doi:10.​1186/​1532-429X-13-S1-P49 CrossRef
41.
go back to reference van den Wijngaard JPHM, Siebes M, Westerhof BE (2009) Comparison of arterial waves derived by classical wave separation and wave intensity analysis in a model of aortic coarctation. Med Biol Eng Compu 47:211–220. doi:10.1007/s11517-008-0387-y CrossRef van den Wijngaard JPHM, Siebes M, Westerhof BE (2009) Comparison of arterial waves derived by classical wave separation and wave intensity analysis in a model of aortic coarctation. Med Biol Eng Compu 47:211–220. doi:10.​1007/​s11517-008-0387-y CrossRef
42.
go back to reference Verhaaren H, De Mey S, Coomans I, Segers P, De Wolf D, Matthys D, Verdonck P (2001) Fixed region of nondistensibility after coarctation repair: in vitro validation of its influence on Doppler peak velocities. J Am Soc Echocardiogr 14:580–587. doi:10.1067/mje.2001.113256 CrossRefPubMed Verhaaren H, De Mey S, Coomans I, Segers P, De Wolf D, Matthys D, Verdonck P (2001) Fixed region of nondistensibility after coarctation repair: in vitro validation of its influence on Doppler peak velocities. J Am Soc Echocardiogr 14:580–587. doi:10.​1067/​mje.​2001.​113256 CrossRefPubMed
43.
go back to reference Vogt M, Kühn A, Baumgartner D, Baumgartner C, Busch R, Kostolny M, Hess J (2005) Impaired elastic properties of the ascending aorta in newborns before and early after successful coarctation repair: proof of a systemic vascular disease of the prestenotic arteries? Circulation 111:3269–3273. doi:10.1161/circulationaha.104.529792 CrossRefPubMed Vogt M, Kühn A, Baumgartner D, Baumgartner C, Busch R, Kostolny M, Hess J (2005) Impaired elastic properties of the ascending aorta in newborns before and early after successful coarctation repair: proof of a systemic vascular disease of the prestenotic arteries? Circulation 111:3269–3273. doi:10.​1161/​circulationaha.​104.​529792 CrossRefPubMed
45.
go back to reference Wendell DC, Samyn MM, Cava JR, Ellwein LM, Krolikowski MM, Gandy KL, Pelech AN, Shadden SC, LaDisa JF Jr (2013) Including aortic valve morphology in computational fluid dynamics simulations: initial findings and application to aortic coarctation. Med Eng Phys 35:723–735. doi:10.1016/j.medengphy.2012.07.015 CrossRefPubMed Wendell DC, Samyn MM, Cava JR, Ellwein LM, Krolikowski MM, Gandy KL, Pelech AN, Shadden SC, LaDisa JF Jr (2013) Including aortic valve morphology in computational fluid dynamics simulations: initial findings and application to aortic coarctation. Med Eng Phys 35:723–735. doi:10.​1016/​j.​medengphy.​2012.​07.​015 CrossRefPubMed
Metadata
Title
Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study
Authors
Liesbeth Taelman
Joris Bols
Joris Degroote
Vivek Muthurangu
Joseph Panzer
Jan Vierendeels
Patrick Segers
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Medical & Biological Engineering & Computing / Issue 2-3/2016
Print ISSN: 0140-0118
Electronic ISSN: 1741-0444
DOI
https://doi.org/10.1007/s11517-015-1336-1

Other articles of this Issue 2-3/2016

Medical & Biological Engineering & Computing 2-3/2016 Go to the issue

Premium Partner