The role of aortic compliance in determination of coarctation severity: Lumped parameter modeling, in vitro study and clinical evaluation

Abstract Early detection and accurate estimation of the extent of coarctation of the aorta (COA) is critical to long-term outcome. Peak-to-peak trans-coarctation pressure gradient (PK dP) higher than 20 mmHg is an indication for interventional/surgical repair. Patients with COA have reduced proximal...

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Bibliographic Details
Published in:Journal of biomechanics 2015-12, Vol.48 (16), p.4229-4237
Main Authors: Keshavarz-Motamed, Zahra, Edelman, Elazer R, Motamed, Payam K, Garcia, Julio, Dahdah, Nagib, Kadem, Lyes
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aorta - physiopathology
Aortic Coarctation - diagnosis
Aortic Coarctation - physiopathology
Aortic Coarctation - therapy
Arterial compliance effect
Biomechanics
Blood pressure
Cardiology
Catheterization
Child
Child, Preschool
Coarctation of the aorta
Compliance
Coronary vessels
Correlation
Defects
Determinants
Diagnostic systems
Female
Heart
Humans
Hypertension
In vitro testing
Male
Mathematical models
Mortality
Multivariate analysis
Patients
Peak to peak pressure gradient
Physical Medicine and Rehabilitation
Retrospective Studies
Stroke Volume
Surgery
Treatment Outcome
Veins & arteries
Ventricular Pressure
Young Adult
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Summary:Abstract Early detection and accurate estimation of the extent of coarctation of the aorta (COA) is critical to long-term outcome. Peak-to-peak trans-coarctation pressure gradient (PK dP) higher than 20 mmHg is an indication for interventional/surgical repair. Patients with COA have reduced proximal and distal aortic compliances. A comprehensive study investigating the effects of variations of proximal COA and systemic compliances on PK dP, and consequently on the COA severity evaluation has never been done. This study evaluates the effect of aortic compliance on diagnostic accuracy of PK dP. Lumped parameter modeling and in vitro experiments were performed for COA severities of 50%, 75% and 90% by area. Modeling and in vitro results were validated against retrospective clinical data of PK dP, measured in 54 patients with COA. Modeling and in vitro . PK dP increases with reduced proximal COA compliance (+36%, +38% and +53% for COA severities of 50%, 75% and 90%, respectively; p
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2015.10.017