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

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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.
Keywords
HYPERTENSION, ARTERIES, STENTS, MODEL, MECHANISMS, IMPLANTATION

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Chicago
Taelman, Liesbeth, Joris Bols, Joris Degroote, Vivek Muthurangu, Joseph Panzer, Jan Vierendeels, and Patrick Segers. 2016. “Differential Impact of Local Stiffening and Narrowing on Hemodynamics in Repaired Aortic Coarctation: An FSI Study.” Medical & Biological Engineering & Computing 54 (2-3): 497–510.
APA
Taelman, L., Bols, J., Degroote, J., Muthurangu, V., Panzer, J., Vierendeels, J., & Segers, P. (2016). Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study. MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 54(2-3), 497–510.
Vancouver
1.
Taelman L, Bols J, Degroote J, Muthurangu V, Panzer J, Vierendeels J, et al. Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study. MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING. HEIDELBERG: SPRINGER HEIDELBERG; 2016;54(2-3):497–510.
MLA
Taelman, Liesbeth, Joris Bols, Joris Degroote, et al. “Differential Impact of Local Stiffening and Narrowing on Hemodynamics in Repaired Aortic Coarctation: An FSI Study.” MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING 54.2-3 (2016): 497–510. Print.
@article{7195525,
  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.},
  author       = {Taelman, Liesbeth and Bols, Joris and Degroote, Joris and Muthurangu, Vivek and Panzer, Joseph and Vierendeels, Jan and Segers, Patrick},
  issn         = {0140-0118},
  journal      = {MEDICAL \& BIOLOGICAL ENGINEERING \& COMPUTING},
  keyword      = {HYPERTENSION,ARTERIES,STENTS,MODEL,MECHANISMS,IMPLANTATION},
  language     = {eng},
  number       = {2-3},
  pages        = {497--510},
  publisher    = {SPRINGER HEIDELBERG},
  title        = {Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study},
  url          = {http://dx.doi.org/10.1007/s11517-015-1336-1},
  volume       = {54},
  year         = {2016},
}

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