Assessment of turbulent blood flow and wall shear stress in aortic coarctation using image-based simulations

Romana Perinajová,Jean-Paul Aben,Joe F Juffermans,Jos J M Westenberg,Hildo J Lamb,Saša Kenjereš,Jonhatan Lorenzo Mercado,Leon Ledoux

doi:10.1186/s12938-021-00921-4

Abstract

In this study, we analyzed turbulent flows through a phantom (a 180^{circ } bend with narrowing) at peak systole and a patient-specific coarctation of the aorta (CoA), with a pulsating flow, using magnetic resonance imaging (MRI) and computational fluid dynamics (CFD). For MRI, a 4D-flow MRI is performed using a 3T scanner. For CFD, the standard k-epsilon , shear stress transport k-omega , and Reynolds stress (RSM) models are applied. A good agreement between measured and simulated velocity is obtained for the phantom, especially for CFD with RSM. The wall shear stress (WSS) shows significant differences between CFD and MRI in absolute values, due to the limited near-wall resolution of MRI. However, normalized WSS shows qualitatively very similar distributions of the local values between MRI and CFD. Finally, a direct comparison between in vivo 4D-flow MRI and CFD with the RSM turbulence model is performed in the CoA. MRI can properly identify regions with locally elevated or suppressed WSS. If the exact values of the WSS are necessary, CFD is the preferred method. For future applications, we recommend the use of the combined MRI/CFD method for analysis and evaluation of the local flow patterns and WSS in the aorta.

Highlights

Coarctation of aorta (CoA) is a congenital condition in which the aorta has a narrowing, usually in the thoracic descending aorta distal to the branching arteries of the aortic arch
Phantom 4D‐flow magnetic resonance imaging (MRI) flow rate The volumetric flow rate was extracted from 11 different locations distributed evenly along the length of the phantom using CAAS MR Solutions v5.0 to test the performance of the MRI acquisition
In terms of computational efficiency, a larger number of transport equations needs to be solved by the Reynolds stress model (RSM) turbulence model when compared to the eddy-viscosity-based models, its computational costs are still much smaller when compared to high-fidelity LES or DNS methods (i.e., O(102 − 103) faster, respectively), which makes it a good choice for the patient-specific clinical applications

Summary

Introduction

Coarctation of aorta (CoA) is a congenital condition in which the aorta has a narrowing, usually in the thoracic descending aorta distal to the branching arteries of the aortic arch. The narrowing of the artery causes flow acceleration, where a turbulent-like flow may occur during the systolic phase [1]. It has been shown that the transitional and turbulent flow in CoA leads to aberrant blood flow in the narrowing and a vortex-like recirculation pattern distal to the stenosis [2]. Due to the stenosis and onset of turbulence, the wall shear stress (WSS) is elevated, and the presence of turbulence may cause oscillations of its values [3]. This type of flow may cause, among others, degradation of the arterial wall, initialization of an aneurysm, and atherosclerosis [4].

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