Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations
Contemporary evaluation and surgical approaches in congenital aortic valve disease have yielded limited success. The ability to evaluate and understand detailed flow characteristics surrounding surgical repair may be beneficial. This study explores the feasibility and utility of echocardiographic-ba...
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2025-07-01
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| author | Shihao Liu Justin T. Tretter Lama Dakik Hani K. Najm Debkalpa Goswami Jennifer K. Ryan Elias Sundström |
| author_facet | Shihao Liu Justin T. Tretter Lama Dakik Hani K. Najm Debkalpa Goswami Jennifer K. Ryan Elias Sundström |
| author_sort | Shihao Liu |
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| description | Contemporary evaluation and surgical approaches in congenital aortic valve disease have yielded limited success. The ability to evaluate and understand detailed flow characteristics surrounding surgical repair may be beneficial. This study explores the feasibility and utility of echocardiographic-based blood speckle imaging (BSI) in assessing pre- and post-operative flow characteristics in those with non-stenotic congenital aortic root disease undergoing aortic valve repair or valve-sparing root replacement (VSRR) surgery. Transesophageal echocardiogram was performed during the pre-operative and post-operative assessment surrounding aortic surgery for ten patients with non-stenotic congenital aortic root disease. BSI, utilizing block-matching algorithms, enabled detailed visualization and quantification of flow parameters from the echocardiographic data. Post-operative BSI unveiled enhanced hemodynamic patterns, characterized by quantified changes suggestive of the absence of stenosis and no more than trivial regurgitation. Rectification of an asymmetric jet and the reversal of flow on the posterior aspect of the ascending aorta resulted in a reduced oscillatory shear index (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>O</mi><mi>S</mi><mi>I</mi></mrow></semantics></math></inline-formula>) of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.0543</mn><mo>±</mo><mn>0.0207</mn></mrow></semantics></math></inline-formula> (pre-op) vs. <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.0275</mn><mo>±</mo><mn>0.0159</mn></mrow></semantics></math></inline-formula> (post-op) and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>p</mi><mo>=</mo><mn>0.0044</mn></mrow></semantics></math></inline-formula>, increased peak wall shear stress of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>1.9423</mn><mo>±</mo><mn>0.6974</mn></mrow></semantics></math></inline-formula> (pre-op) vs. <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>3.6956</mn><mo>±</mo><mn>1.4934</mn></mrow></semantics></math></inline-formula> (post-op) and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>p</mi><mo>=</mo><mn>0.0035</mn></mrow></semantics></math></inline-formula>, and increased time-averaged wall shear stress of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.6885</mn><mo>±</mo><mn>0.8004</mn></mrow></semantics></math></inline-formula> (pre-op) vs. <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.8312</mn><mo>±</mo><mn>0.303</mn></mrow></semantics></math></inline-formula> (post-op) and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>p</mi><mo>=</mo><mn>0.23</mn></mrow></semantics></math></inline-formula>. This correction potentially attenuates cellular alterations within the endothelium. This study demonstrates that children and young adults with non-stenotic congenital aortic root disease undergoing valve-preserving operations experience significant improvements in flow dynamics within the left ventricular outflow tract and aortic root, accompanied by a reduction in <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>O</mi><mi>S</mi><mi>I</mi></mrow></semantics></math></inline-formula>. These hemodynamic enhancements extend beyond the conventional echocardiographic assessments, offering immediate and valuable insights into the efficacy of surgical interventions. |
| format | Article |
| id | doaj-art-7b03b7486c8d485c997448e8e1d53c81 |
| institution | Kabale University |
| issn | 2306-5354 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
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| series | Bioengineering |
| spelling | doaj-art-7b03b7486c8d485c997448e8e1d53c812025-08-20T03:36:13ZengMDPI AGBioengineering2306-53542025-07-0112777610.3390/bioengineering12070776Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving OperationsShihao Liu0Justin T. Tretter1Lama Dakik2Hani K. Najm3Debkalpa Goswami4Jennifer K. Ryan5Elias Sundström6Department of Mathematics, KTH Royal Institute of Technology, 114 28 Stockholm, SwedenCongenital Valve Procedural Planning Program, Department of Pediatric Cardiology and Division of Pediatric Cardiac Surgery, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USACongenital Valve Procedural Planning Program, Department of Pediatric Cardiology and Division of Pediatric Cardiac Surgery, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Pediatric Cardiology, Cleveland Clinic, Cleveland, OH 44195, USACardiovascular Innovation Research Center, Department of Cardiovascular Medicine, The Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Mathematics, KTH Royal Institute of Technology, 114 28 Stockholm, SwedenDepartment of Engineering Mechanics, FLOW Research Center, KTH Royal Institute of Technology, 100 44 Stockholm, SwedenContemporary evaluation and surgical approaches in congenital aortic valve disease have yielded limited success. The ability to evaluate and understand detailed flow characteristics surrounding surgical repair may be beneficial. This study explores the feasibility and utility of echocardiographic-based blood speckle imaging (BSI) in assessing pre- and post-operative flow characteristics in those with non-stenotic congenital aortic root disease undergoing aortic valve repair or valve-sparing root replacement (VSRR) surgery. Transesophageal echocardiogram was performed during the pre-operative and post-operative assessment surrounding aortic surgery for ten patients with non-stenotic congenital aortic root disease. BSI, utilizing block-matching algorithms, enabled detailed visualization and quantification of flow parameters from the echocardiographic data. Post-operative BSI unveiled enhanced hemodynamic patterns, characterized by quantified changes suggestive of the absence of stenosis and no more than trivial regurgitation. Rectification of an asymmetric jet and the reversal of flow on the posterior aspect of the ascending aorta resulted in a reduced oscillatory shear index (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>O</mi><mi>S</mi><mi>I</mi></mrow></semantics></math></inline-formula>) of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.0543</mn><mo>±</mo><mn>0.0207</mn></mrow></semantics></math></inline-formula> (pre-op) vs. <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.0275</mn><mo>±</mo><mn>0.0159</mn></mrow></semantics></math></inline-formula> (post-op) and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>p</mi><mo>=</mo><mn>0.0044</mn></mrow></semantics></math></inline-formula>, increased peak wall shear stress of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>1.9423</mn><mo>±</mo><mn>0.6974</mn></mrow></semantics></math></inline-formula> (pre-op) vs. <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>3.6956</mn><mo>±</mo><mn>1.4934</mn></mrow></semantics></math></inline-formula> (post-op) and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>p</mi><mo>=</mo><mn>0.0035</mn></mrow></semantics></math></inline-formula>, and increased time-averaged wall shear stress of <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.6885</mn><mo>±</mo><mn>0.8004</mn></mrow></semantics></math></inline-formula> (pre-op) vs. <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mn>0.8312</mn><mo>±</mo><mn>0.303</mn></mrow></semantics></math></inline-formula> (post-op) and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>p</mi><mo>=</mo><mn>0.23</mn></mrow></semantics></math></inline-formula>. This correction potentially attenuates cellular alterations within the endothelium. This study demonstrates that children and young adults with non-stenotic congenital aortic root disease undergoing valve-preserving operations experience significant improvements in flow dynamics within the left ventricular outflow tract and aortic root, accompanied by a reduction in <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mrow><mi>O</mi><mi>S</mi><mi>I</mi></mrow></semantics></math></inline-formula>. These hemodynamic enhancements extend beyond the conventional echocardiographic assessments, offering immediate and valuable insights into the efficacy of surgical interventions.https://www.mdpi.com/2306-5354/12/7/776blood speckle imagingcongenital heart diseaseaortic valve repairhemodynamicsaortic valve-sparing root replacementaortic regurgitation |
| spellingShingle | Shihao Liu Justin T. Tretter Lama Dakik Hani K. Najm Debkalpa Goswami Jennifer K. Ryan Elias Sundström Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations Bioengineering blood speckle imaging congenital heart disease aortic valve repair hemodynamics aortic valve-sparing root replacement aortic regurgitation |
| title | Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations |
| title_full | Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations |
| title_fullStr | Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations |
| title_full_unstemmed | Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations |
| title_short | Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations |
| title_sort | flow characteristics by blood speckle imaging in non stenotic congenital aortic root disease surrounding valve preserving operations |
| topic | blood speckle imaging congenital heart disease aortic valve repair hemodynamics aortic valve-sparing root replacement aortic regurgitation |
| url | https://www.mdpi.com/2306-5354/12/7/776 |
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