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Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Two more relatively common congenital cardiology treatments are for coarctation of the aorta and pulmonary artery stenosis. Each of these is treated by placing a (relatively large) stent within the obstruction. An aortic coarctation is often a very significant stenosis, around the superior aspect of the descending thoracic aorta. This can be so severe as to make passage of a catheter quite challenging. Once a stiff wire has been passed via the femoral artery and through the stenosis, pressure measurements are taken on either side of the coarctation. The difference in peak proximal to distal pressure is known as a pressure gradient. Once an appropriately sized stent has been deployed, the pressure gradient is again measured to check the value of the treatment. If not significantly reduced, the stent may be dilated using a larger balloon.
Central nervous system
Published in David A Lisle, Imaging for Students, 2012
Most cerebral artery aneurysms are congenital ‘berry’ aneurysms. Berry aneurysms occur in 2 per cent of the population and are multiple in 10 per cent of cases. Increased incidence of berry aneurysms occurs in association with coarctation of the aorta and autosomal dominant polycystic kidney disease. Most berry aneurysms occur around the circle of Willis, the most common sites being:Anterior communicating arteryPosterior communicating arteryMiddle cerebral arteryBifurcation of internal carotid arteryTip of basilar artery.
The effect of including increased arterial stiffness in the upper body when modelling Coarctation of the Aorta
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Dilan Pathirana, Barbara Johnston, Peter Johnston
Coarctation of the Aorta (CoA) is a congenital heart disease, involving a narrowing in the aorta, which results in increased blood flow to regions of the body that are supplied by arteries upstream of the coarctation (generally the upper body) and decreased blood flow to downstream regions (generally the lower body) (Rao 2005). It is considered a serious disease with a mean age of mortality of 34 years if left untreated (Campbell 1970), and it affects 3–4 in every 10,000 live births (van der Linde et al. 2011). Although several treatments are available that resolve the coarctation, treated patients still experience decreased life expectancies compared to healthy populations, for treatments where data is available (Vriend and Mulder 2005; Nguyen and Cook 2015). Long-term or mortality data for patients treated with some treatments, such as stents, are unavailable as these treatments have only been applied in CoA patients in recent decades; hence, reviews of the treatments for CoA often are unable to recommend a particular treatment as being superior (Pádua et al. 2012).
In silico modeling for personalized stenting in aortic coarctation
Published in Engineering Applications of Computational Fluid Mechanics, 2022
Dandan Ma, Yong Wang, Mueed Azhar, Ansgar Adler, Michael Steinmetz, Martin Uecker
Coarctation of the aorta (CoA) refers to a local narrowing of the aortic arch. It makes up 6–8 of all congenital heart diseases (Rafieianzab et al., 2021), and is often associated with other cardiovascular diseases, such as aortic arch hypoplasia, subaortic stenosis, ventricular and atrial septal defects (Alkashkari et al., 2019; Hoffman & Kaplan, 2002; Reller et al., 2008). The coarctation leads to high blood pressure and thus heart damage. Stent intervention, which is generally performed based on clinical experience without theoretical guidance, is a recommended therapy to reduce the pressure gradient and restore blood flow.