Skip to main content

Assessment of Haemodynamic Remodeling in Fetal Aortic Coarctation Using a Lumped Model of the Circulation

  • Conference paper
  • First Online:
Functional Imaging and Modelling of the Heart (FIMH 2017)

Abstract

Introduction: Aortic coarctation is one of the most difficult cardiac defects to diagnose before birth, and it accounts for 8% of congenital heart diseases. Antenatal diagnosis is crucial for early treatment of the neonate and to decrease the risk of morbidity and mortality; however the fetal hemodynamic changes are not fully understood and current imaging methods are limited to accurately diagnosis this congenital defect. Objective: We propose to use a lumped model of the fetal circulation to provide insights into the hemodynamic changes in fetuses with aortic coarctation, and thus helping to improve its diagnosis. Methods: To achieve this goal a patient-specific lumped model of the fetal circulation was implemented in OpenCOR, including the modeling of different types and degrees of aortic coarctation. A parametric study of degree and type of coarctation was performed, where blood flow distribution, cerebroplacental ratio, pressure drop over the coarctation and left ventricular pressure were quantified. Results: Obvious changes in the fetal hemodynamics were observed only from 80% of coarctation, corresponding to the clinically used cut-off for pressure drop of 20 mmHg. Furthermore, the observed hemodynamic changes were different depending on the location and degree of the coarctation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Buyens, A., Gyselaers, W., Coumans, A., Al Nasiry, S., Willekes, C., Boshoff, D., Witters, I., et al.: Difficult prenatal diagnosis: fetal coarctation. FVV ObGyn. 4, 230–236 (2012)

    Google Scholar 

  2. Espinoza, J., Romero, R., Kusanovic, J.P., Gotsch, F., et al.: Prenatal diagnosis of coarctation of the aorta with the multiplanar display and B-flow imaging using 4-dimensional sonography. J. Ultrasound Med. 28, 1375–1378 (2009). https://doi.org/10.7863/jum.2009.28.10.1375

    Article  Google Scholar 

  3. Achiron, R., Zimand, S., Rotstein, Z., et al.: Fetal aortic arch measurements between 14 and 38 weeks’ gestation: in‐utero ultrasonographic study. Ultrasound Obstet. Gynecol. 15, 226–230 (2000). https://doi.org/10.7863/jum.2009.28.10.1375

    Article  Google Scholar 

  4. Matsui, H., Mellander, M., Roughton, M., et al.: Morphological and physiological predictors of fetal aortic coarctation. Circulation 118, 1793–1801 (2008). https://doi.org/10.1161/CIRCULATIONAHA.108.787598

    Article  Google Scholar 

  5. Kenny, J.F., Plappert, T., Sutton, M.S.J., et al.: Changes in intracardiac blood flow velocities and right and left ventricular stroke volumes with gestational age in the normal human fetus: a prospective doppler echocardiographic study. Circulation 74, 1208–1216 (1986). https://doi.org/10.1161/01.CIR.74.6.1208

    Article  Google Scholar 

  6. Mukai, Y., Samura, O., Teraoka, Y., Sasaki, M.: Prenatal diagnosis of coarctation of the aorta using the three-vessel view by calculating the ratio of the diameter of the aortic root to that of the pulmonary artery. Ultrasound Obs. Gynecol. 44, 1793–1801 (2014). https://doi.org/10.1002/uog.14118

    Google Scholar 

  7. Garcia-Canadilla, P., Rudenick, P.A., Crispi, F., Cruz-Lemini, M., Palau, G., Camara, O., et al.: A computational model of the fetal circulation to quantify blood redistribution in intrauterine growth restriction. PLoS Comput. Biol. 10, e1003667 (2014). doi:10.1371/journal.pcbi.1003667

    Article  Google Scholar 

  8. Garcia-Canadilla, P., Rudenick, P.A., Crispi, F., Cruz-Lemini, M., Triunfo, S., Nadal, A., et al.: Patient-specific estimates of vascular and placental properties in growth-restricted fetuses based on a model of the fetal circulation. Placenta 36, 981–989 (2015). doi:10.1016/j.placenta.2015.07.130

    Article  Google Scholar 

  9. Hunter, P.: OpenCOR Tutorial (2016)

    Google Scholar 

  10. Szpinda, M.: Length growth of the various aortic segments in human foetuses. Folia Morphol. 67, 245–250 (2008)

    Google Scholar 

  11. Yamamoto, Y., Khoo, N.S., Brooks, P.A., Savard, W., et al.: Severe left heart obstruction with retrograde arch flow influences fetal cerebral and placental blood flow. Ultrasound Obstet. Gynecol. 42, 294–299 (2013). doi:10.1002/uog.12448

    Article  Google Scholar 

  12. Beauchesne, L.M., Connolly, H.M., et al.: Coarctation of the aorta: outcome of pregnancy. J. Am. Coll. Cardiol. 38, 1728–1733 (2001). https://doi.org/10.1016/S0735-1097(01)01617-5

    Article  Google Scholar 

Download references

Acknowledgments

This study was partially supported by the Spanish Ministry of Economy and Competitiveness (grant TIN2014-52923-R; Maria de Maeztu Units of Excellence Programme - MDM-2015-0502), FEDER and the European Union Horizon 2020 Programme for Research and Innovation, under grant agreement No. 642676 (CardioFunXion).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Paula Giménez Mínguez .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this paper

Cite this paper

Giménez Mínguez, P. et al. (2017). Assessment of Haemodynamic Remodeling in Fetal Aortic Coarctation Using a Lumped Model of the Circulation. In: Pop, M., Wright, G. (eds) Functional Imaging and Modelling of the Heart. FIMH 2017. Lecture Notes in Computer Science(), vol 10263. Springer, Cham. https://doi.org/10.1007/978-3-319-59448-4_45

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-59448-4_45

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59447-7

  • Online ISBN: 978-3-319-59448-4

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics