LETTER


Influence of Geometric Changes in the Thoracic Aorta due to Arterial Switch Operations on the Wall Shear Stress Distribution



Tomohiro Fukui1, *, Hiroaki Asama1, Manabu Kimura2, Toshiyuki Itoi3, Koji Morinishi1
1 Department of Mechanical Engineering, Kyoto Institute of Technology, Matsugasaki Goshokaido-cho, Sakyo-ku, Kyoto 606-8585, Japan
2 Kyoto Second Red Cross Hospital, Haruobi-cho 355-5, Kamigyo-ku, Kyoto 602-8026, Japan
3 Department of Pediatric Cardiology and Nephrology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto 602-0841, Japan


Article Metrics

CrossRef Citations:
0
Total Statistics:

Full-Text HTML Views: 1893
Abstract HTML Views: 964
PDF Downloads: 388
ePub Downloads: 206
Total Views/Downloads: 3451
Unique Statistics:

Full-Text HTML Views: 900
Abstract HTML Views: 578
PDF Downloads: 254
ePub Downloads: 140
Total Views/Downloads: 1872



© 2017 Fukui et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Mechanical Engineering, Kyoto Institute of Technology, Matsugasaki Goshokaido-cho, Sakyo-ku, Kyoto 606-8585, Japan; Tel: +81-75-724-7314; Fax: +81-75-724-7300; E-mails: fukui@kit.ac.jp, tom1214@hotmail.co.jp


Abstract

Background:

The transposition of the great arteries (TGA) is one of the most severe congenital heart diseases. The arterial switch operation (ASO) is the preferred procedure to treat TGA. Although numerous reports have shown good results after ASOs, some patients suffer from circulatory system problems following the procedure. One reason for problems post-ASO is the local changes in the curvature and torsion of the thoracic aorta.

Objective:

The influence of these geometric changes on the blood flow field needs to be investigated in detail to consider possible cardiovascular problems after an ASO.

Method:

In this study, we conduct blood flow simulations in the thoracic aorta post-ASO, evaluate geometric changes in the aorta due to the ASO in terms of curvature and torsion, and consider the effect of geometric changes on blood flow in the aorta.

Results:

It was found that a large curvature near the aortic root causes an increase in the maximal wall shear stress value in the middle systole. Moreover, a large torsion results in a circumferential change in the maximal wall shear stress region. It was also found that the maximal wall shear stress in the post-ASO models is significantly higher than that in the normal models. This indicates that the aortic aneurysm initiation risk for a post-ASO artery may be higher than that of a normal artery.

Conclusion:

To reduce the risk of initiating an aneurism, it is suggested that the curvature near the aortic root should be decreased during the ASO.

Keywords: Aneurysm, Arterial switch operation, Blood flow simulation, Curvature, Torsion, Transposition of the great arteries, Wall shear stress.