Goubergrits L, Riesenkampff E, Yevtushenko P, Schaller J, Kertzscher U, Berger F, Kuehne T
Biofluid Mechanics Laboratory, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany,
Ann Biomed Eng. 2015 Jan;43(1):168-76. doi: 10.1007/s10439-014-1116-3. Epub 2014 Sep 16.
Pressure drop associated with coarctation of the aorta (CoA) can be successfully treated surgically or by stent placement. However, a decreased life expectancy associated with altered aortic hemodynamics was found in long-term studies. Image-based computational fluid dynamics (CFD) is intended to support particular diagnoses, to help in choosing between treatment options, and to improve performance of treatment procedures. This study aimed to prove the ability of CFD to improve aortic hemodynamics in CoA patients. In 13 patients (6 males, 7 females; mean age 25 ± 14 years), we compared pre- and post-treatment peak systole hemodynamics [pressure drops and wall shear stress (WSS)] vs. virtual treatment as proposed by biomedical engineers. Anatomy and flow data for CFD were based on MRI and angiography. Segmentation, geometry reconstruction and virtual treatment geometry were performed using the software ZIBAmira, whereas peak systole flow conditions were simulated with the software ANSYS(®) Fluent(®). Virtual treatment significantly reduced pressure drop compared to post-treatment values by a mean of 2.8 ± 3.15 mmHg, which significantly reduced mean WSS by 3.8 Pa. Thus, CFD has the potential to improve post-treatment hemodynamics associated with poor long-term prognosis of patients with coarctation of the aorta. MRI-based CFD has a huge potential to allow the slight reduction of post-treatment pressure drop, which causes significant improvement (reduction) of the WSS at the stenosis segment.
与主动脉缩窄（CoA）相关的压力降可通过手术或支架置入成功治疗。然而，长期研究发现，主动脉血流动力学改变会导致预期寿命缩短。基于图像的计算流体动力学（CFD）旨在辅助特定诊断，帮助选择治疗方案，并改善治疗程序的效果。本研究旨在证明CFD改善CoA患者主动脉血流动力学的能力。在13例患者（6例男性，7例女性；平均年龄25±14岁）中，我们将治疗前后的收缩期峰值血流动力学[压力降和壁面剪应力（WSS）]与生物医学工程师提出的虚拟治疗进行了比较。CFD的解剖结构和血流数据基于MRI和血管造影。使用ZIBAmira软件进行分割、几何重建和虚拟治疗几何建模，而使用ANSYS(®) Fluent(®)软件模拟收缩期峰值血流情况。与治疗后的值相比，虚拟治疗使压力降平均显著降低2.8±3.15 mmHg，平均WSS显著降低3.8 Pa。因此，CFD有潜力改善与主动脉缩窄患者长期预后不良相关的治疗后血流动力学。基于MRI的CFD有巨大潜力使治疗后压力降略有降低，这会导致狭窄段的WSS显著改善（降低）。
