Abstract 1089: Noninvasive Assessment Of Aortic Biomechanics Using 4-D Flow And Cardiovascular Magnetic Resonance In A Porcine Model Of Aortic Coarctation

Abstract

Objectives: Aortic coarctation (COA) is a congenital heart disease that results from narrowing of the aorta, contributing to increased cardiovascular morbidity. Current animal models are limited by stenotic mechanism and study longevity. We introduce a porcine model of COA, treated with a novel growth stent and imaged with advanced MRI techniques, to obtain hemodynamic metrics. Methods: A total of 14 piglets, 4 sham, 4 coarcted controls (CC) and 6 coarcted stents (CS), underwent surgical creation of a COA. The timeline is detailed in Figure 1. Serial imaging was obtained on a 3.0T MRI scanner. Hemodynamic metrics were acquired in predefined vascular planes (Ensight, CEI) to assess net flow, velocities and helical or vortical flow. CMR image analysis using cvi42 (Circle, Canada) included T1 maps and cardiac function. Results: Analyses are shown at 20 weeks. For CMR, there were no differences in cardiac function metrics, left ventricular mass or T1 mapping. In the 4D Flow analysis, shown in Figure 2, ascending aortic flow averages 62.5 mL/cycle in the CS group, higher than the sham and CC groups (p= <0.05). Both CS and CC animals have increased post-stenotic velocities (>1.5m/s), compared to the sham aorta (p= 0.01). All coarcted aortas, both CS and CC, exhibited helical flow and post-stenotic dilatation. Conclusions: No hemodynamic differences were seen with CMR, reflecting minimal adverse myocardial remodeling. 4D MRI data revealed locational differences in flow, velocity and collateralization. In conclusion, this work illustrates a successful longitudinal large animal model of COA and validates advanced imaging methods in the study of vascular hemodynamics.