A systematic quantification of hemodynamic differences persisting after aortic coarctation repair
IntroductionAortic coarctation (CoA) comprises 6%–8% of all congenital heart diseases and is the second most common cardiovascular disease requiring neonatal surgical correction. However, patients remain at high risk for long-term complications, notably recoarctation.MethodsHemodynamic simulations w...
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Frontiers Media S.A.
2025-06-01
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| author | Christopher Jensen Christopher Jensen Arash Ghorbannia David Urick David Urick G. Chad Hughes Amanda Randles |
| author_facet | Christopher Jensen Christopher Jensen Arash Ghorbannia David Urick David Urick G. Chad Hughes Amanda Randles |
| author_sort | Christopher Jensen |
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| description | IntroductionAortic coarctation (CoA) comprises 6%–8% of all congenital heart diseases and is the second most common cardiovascular disease requiring neonatal surgical correction. However, patients remain at high risk for long-term complications, notably recoarctation.MethodsHemodynamic simulations were performed in a group of six patients following CoA repair, as compared to a group of age and sex-matched healthy controls. Progressive narrowing at the CoA repair site was modeled to simulate the recoarctation process. Key measurements included time-averaged wall shear stress (TAWSS) in the aortic arch and CoA repair site.ResultsRepaired aortas demonstrated significantly higher TAWSS compared to healthy aortas in the aortic arch (3.46 vs 1.24 Pa, p< 0.05) and CoA repair site (4.34 vs 1.56 Pa, p< 0.05). A pronounced nonlinear relationship between stenosis severity and TAWSS was observed suggesting that increasing stenosis corresponds to progressively abnormal shear stress.DiscussionThe persistent high TAWSS in CoA-repaired aortas may underlie the poor long-term outcomes observed in this population. The identified nonlinear relationship between stenosis severity and TAWSS magnitude suggests a potential positive feedback mechanism, where abnormal shear stress exacerbates pathologic remodeling in the repaired aorta, highlighting the potential role of hemodynamic simulations in the clinical management of CoA patients. |
| format | Article |
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| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-b5b2fd7926a3426b89762d133dbfc2dd2025-08-20T02:24:17ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852025-06-011310.3389/fbioe.2025.15392561539256A systematic quantification of hemodynamic differences persisting after aortic coarctation repairChristopher Jensen0Christopher Jensen1Arash Ghorbannia2David Urick3David Urick4G. Chad Hughes5Amanda Randles6Department of Biomedical Engineering, Duke University, Durham, NC, United StatesDivision of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, United StatesDepartment of Biomedical Engineering, Duke University, Durham, NC, United StatesDepartment of Biomedical Engineering, Duke University, Durham, NC, United StatesDepartment of Radiology, Duke University Medical Center, Durham, NC, United StatesDivision of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, United StatesDepartment of Biomedical Engineering, Duke University, Durham, NC, United StatesIntroductionAortic coarctation (CoA) comprises 6%–8% of all congenital heart diseases and is the second most common cardiovascular disease requiring neonatal surgical correction. However, patients remain at high risk for long-term complications, notably recoarctation.MethodsHemodynamic simulations were performed in a group of six patients following CoA repair, as compared to a group of age and sex-matched healthy controls. Progressive narrowing at the CoA repair site was modeled to simulate the recoarctation process. Key measurements included time-averaged wall shear stress (TAWSS) in the aortic arch and CoA repair site.ResultsRepaired aortas demonstrated significantly higher TAWSS compared to healthy aortas in the aortic arch (3.46 vs 1.24 Pa, p< 0.05) and CoA repair site (4.34 vs 1.56 Pa, p< 0.05). A pronounced nonlinear relationship between stenosis severity and TAWSS was observed suggesting that increasing stenosis corresponds to progressively abnormal shear stress.DiscussionThe persistent high TAWSS in CoA-repaired aortas may underlie the poor long-term outcomes observed in this population. The identified nonlinear relationship between stenosis severity and TAWSS magnitude suggests a potential positive feedback mechanism, where abnormal shear stress exacerbates pathologic remodeling in the repaired aorta, highlighting the potential role of hemodynamic simulations in the clinical management of CoA patients.https://www.frontiersin.org/articles/10.3389/fbioe.2025.1539256/fullaortic coarctationcomputational fluid dynamicslate aneurysmal degenerationrestenosislong-term complications of coarctation |
| spellingShingle | Christopher Jensen Christopher Jensen Arash Ghorbannia David Urick David Urick G. Chad Hughes Amanda Randles A systematic quantification of hemodynamic differences persisting after aortic coarctation repair Frontiers in Bioengineering and Biotechnology aortic coarctation computational fluid dynamics late aneurysmal degeneration restenosis long-term complications of coarctation |
| title | A systematic quantification of hemodynamic differences persisting after aortic coarctation repair |
| title_full | A systematic quantification of hemodynamic differences persisting after aortic coarctation repair |
| title_fullStr | A systematic quantification of hemodynamic differences persisting after aortic coarctation repair |
| title_full_unstemmed | A systematic quantification of hemodynamic differences persisting after aortic coarctation repair |
| title_short | A systematic quantification of hemodynamic differences persisting after aortic coarctation repair |
| title_sort | systematic quantification of hemodynamic differences persisting after aortic coarctation repair |
| topic | aortic coarctation computational fluid dynamics late aneurysmal degeneration restenosis long-term complications of coarctation |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2025.1539256/full |
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