Towards personalized cardiology for coarctation: computational-mechanics and imaged-based diagnostic frameworks*

Coarctation of the aorta (COA) is an obstruction of the aorta distal to the left subclavian artery with different hemodynamic severity and clinical manifestations, varying from mild COA to severe narrowing while accompanied by other cardiovascular diseases. Despite advancements in interventions, life expectancy for COA patients remains low due to morbidity.

The sources of morbidity can be explained on the basis of adverse hemodynamics: abnormal flow patterns and bio-mechanical forces, often categorized by disturbed and turbulent flow, and in some cases by an increase in the heart workload, leading to the development and progression of disease. Therefore, flow quantification can be greatly useful for accurate and early diagnosis.

In this work, a computational-mechanics and imaging-based framework was developed that functions as a diagnostic method for COA. It quantifies 3-D local fluid dynamics and global hemodynamics (heart workload) non-invasively in COA patients based on patient-specific hemodynamic input parameters. The framework was validated against pre and post-intervention clinical data (cardiac catheterization and Doppler echocardiography) in 25 patients.