Effective diagnosis of COA hinges on quantifications of the global hemodynamics (heart
function metrics and workload), and the local hemodynamics (3-dimensional flow
dynamics in COA). In this study, we developed an image-based framework that can
quantify local and global hemodynamics for COA diagnosis. The proposed framework
uses lattice Boltzmann method and lumped-parameter modeling that only needs routine
non-invasive clinical patient data. The computational framework was validated against
clinical cardiac catheterization data and Doppler echocardiographic measurements.
One of the complicating factors of COA is its common association with mixed valvular
diseases (MVD), which include varying combinations of aortic and mitral valve
pathologies. Treatment strategies for these patients are quite unclear and differ from
patient to patient. In order to evaluate risk factors and create guidelines for intervention
aimed at minimizing the progression of cardiovascular disease, the impact of COA and
MVD on aortic fluid dynamics in patients with COA and MVD was investigated in this
thesis. Our results show that interaction of MVD with COA fluid dynamics may amplify
adverse hemodynamic effects especially downstream of COA and may contribute to
speed up the progression of the disease. The results suggest that some more aggressive
surgical approaches may be required as regularly chosen current surgical techniques may
not be optimal for patients with both COA and MVD.
The appropriate surgical technique for COA repair often remains unclear for adult
patients. Extra-anatomical bypass grafting has been recommended in some of the COA
cases. To effectively evaluate risk status and create guidelines for intervention, precise
quantification of aortic fluid dynamics and hemodynamics is required. We used a patient-specific numerical framework to investigate the impact of bypass grafts on aortic fluid
dynamics in patients with COA. This study can partially explain the complications
associated in patients with COA who underwent bypass grafting. / Dissertation / Doctor of Philosophy (PhD) / Coarctation of the aorta is a congenital narrowing of the proximal descending aorta which
coexists with other cardiovascular diseases. Although accurate and early
diagnosis of coarctation hinges on blood flow quantification, proper diagnostic methods
for coarctation still lack because fluid-dynamics methods that can be used for accurate
flow quantification are not well developed yet. We developed an image-based patient-specific computational framework that can quantify hemodynamics in patients with
coarctation. Moreover, we investigated the impact of coarctation coexisting with other
diseases and its interventions on hemodynamics to answer clinical questions.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/27157 |
| Date | January 2021 |
| Creators | Sadeghi, Reza |
| Contributors | Keshavarz-Motamed, Zahra, Mechanical Engineering |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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