Related Experiment Video
Updated: Jul 23, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Using computed tomography angiography and computational fluid dynamics to study aortic coarctation in different arch
Jinjie Qin1, Da Ouyang2, Taocui Yan3
1Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Insights
Children with aortic coarctation (CoA) and gothic aortic arches show altered arch morphology and hemodynamics. Computational fluid dynamics (CFD) reveals high, turbulent flow in gothic arches, impacting aortic development.
Area of Science:
- Cardiovascular Imaging
- Pediatric Cardiology
- Biomedical Engineering
Background:
- Aortic coarctation (CoA) is a congenital heart defect affecting aortic arch development.
- Variations in aortic arch morphology, such as gothic, crenel, and romanesque arches, may influence hemodynamics in children with CoA.
Purpose of the Study:
- To compare computed tomography angiography (CTA) imaging characteristics of gothic, crenel, and romanesque aortic arches in children with CoA.
- To apply computational fluid dynamics (CFD) to evaluate hemodynamic changes in children with gothic aortic arches and CoA.
Main Methods:
- Retrospective analysis of CTA data from 95 children with CoA, categorizing aortic arch morphology.
- Quantitative comparison of arch dimensions (D1-D5/AOA, AAO-DAO angle, TAO-DAO angle, A/T ratio) among the three arch types.
- CFD modeling to assess pressure gradients and flow patterns in children with gothic arches.
Main Results:
- Significant differences observed in D3/AOA, D4/AOA, D5/AOA, AAO-DAO angle, and A/T ratio among the arch types (P < 0.05).
- Gothic arches exhibited smaller D4/AOA and D5/AOA compared to crenel arches, and smaller D3/AOA and D5/AOA compared to romanesque arches.
- CFD indicated a significant pressure drop (58 mmHg) and high, turbulent flow in the isthmus and descending aorta of children with gothic arches.
Conclusions:
- Gothic aortic arches are prevalent in CoA and associated with altered aortic arch dimensions and potentially adverse effects on aortic development.
- CFD is a valuable tool for assessing hemodynamic alterations in pediatric CoA patients with varying aortic arch morphologies.
Objective:
To study the differences in computed tomography angiography (CTA) imaging of gothic arches, crenel arches, and romanesque arches in children with Aortic Coarctation (CoA), and to apply computational fluid dynamics (CFD) to study hemodynamic changes in CoA children with gothic arch aorta.
Methods:
The case data and CTA data of children diagnosed with CoA (95 cases) in our hospital were retrospectively collected, and the morphology of the aortic arch in the children was defined as gothic arch (n = 27), crenel arch (n = 25) and romanesque arch (n = 43). The three groups were compared with D1/AOA, D2/AOA, D3/AOA, D4/AOA, D5/AOA, and AAO-DAO angle, TAO-DAO angle, and aortic arch height to width ratio (A/T). Computational fluid dynamics was applied to assess hemodynamic changes in children with gothic arches.
Results:
There were no significant differences between D1/AOA and D2/AOA among gothic arch, crenel arch, and romanesque arch (P > 0.05). The differences in D3/AOA, D4/AOA, and D5/AOA among the three groups were statistically significant (P < 0.05), D4/AOA, D5/AOA of the gothic arch group were smaller than the crenel arch group, and the D3/AOA and D5/AOA of the gothic arch group were smaller than the romanesque arch group (P < 0.05). The difference in AAO-DAO angle among the three groups was statistically significant (P < 0.05), and the AAO-DAO angle of gothic arch was smaller than that of romanesque arch and crenel arch group (P < 0.05). There was no significant difference in the TAO-DAO angle between the three groups (P > 0.05). The difference in A/T values among the three groups was statistically significant (P < 0.05), and the A/T values: gothic arch > romanesque arch > crenel arch (P < 0.05). The CFD calculation of children with gothic arch showed that the pressure drop between the distal stenosis and the descending aorta was 58 mmHg, and the flow rate at the isthmus and descending aorta was high and turbulent.
Conclusion:
Gothic aortic arch is common in CoA, it may put adverse effects on the development of the aortic isthmus and descending aorta, and its A/T value and AAO-DAO angle are high. CFD could assess hemodynamic changes in CoA.
