Ladisa John F, Taylor Charles A, Feinstein Jeffrey A
Department of Biomedical Engineering, Marquette University.
Prog Pediatr Cardiol. 2010 Dec 1;30(1):45-49. doi: 10.1016/j.ppedcard.2010.09.006.
Coarctation of the aorta (CoA) is often considered a relatively simple disease, but long-term outcomes suggest otherwise as life expectancies are decades less than in the average population and substantial morbidity often exists. What follows is an expanded version of collective work conducted by the authors' and numerous collaborators that was presented at the 1st International Conference on Computational Simulation in Congenital Heart Disease pertaining to recent advances for CoA. The work begins by focusing on what is known about blood flow, pressure and indices of wall shear stress (WSS) in patients with normal vascular anatomy from both clinical imaging and the use of computational fluid dynamics (CFD) techniques. Hemodynamic alterations observed in CFD studies from untreated CoA patients and those undergoing surgical or interventional treatment are subsequently discussed. The impact of surgical approach, stent design and valve morphology are also presented for these patient populations. Finally, recent work from a representative experimental animal model of CoA that may offer insight into proposed mechanisms of long-term morbidity in CoA is presented.
主动脉缩窄（CoA）通常被认为是一种相对简单的疾病，但长期结果却并非如此，因为其预期寿命比普通人群短数十年，且常常存在严重的发病率。以下是作者及其众多合作者所开展的集体工作的扩展版本，该工作曾在第一届先天性心脏病计算模拟国际会议上发表，内容涉及CoA的最新进展。这项工作首先聚焦于通过临床成像和计算流体动力学（CFD）技术，了解具有正常血管解剖结构的患者的血流、压力和壁面切应力（WSS）指数。随后讨论了未经治疗的CoA患者以及接受手术或介入治疗的患者在CFD研究中观察到的血流动力学改变。还介绍了手术方式、支架设计和瓣膜形态对这些患者群体的影响。最后，展示了来自CoA代表性实验动物模型的近期研究成果，这些成果可能有助于深入了解CoA长期发病的潜在机制。
