Blood Flow Manipulation in the Aorta With Coarctation and Arch Narrowing for Pediatric Subjects

Abstract The characteristics of blood flow in an abnormal pediatric aorta with an aortic coarctation and aortic arch narrowing are examined using direct numerical simulations and patient-specific boundary conditions. The blood flow simulations of a normal pediatric aorta are used for comparison to identify unique flow features resulting from the aorta geometrical anomalies. Despite flow similarities compared to the flow in normal aortic arch, the flow velocity decreases with an increase in pressure, wall shear stress, and vorticity around both anomalies. The presence of wall shear stresses in the trailing indentation region and aorta coarctation opposing the primary flow direction suggests that there exist recirculation zones in the aorta. The discrepancy in relative flowrates through the top and bottom of the aorta outlets, and the pressure drop across the coarctation, implies a high blood pressure in the upper body and a low blood pressure in the lower body. We propose using flow manipulators prior to the aortic arch and coarctation to lower the wall shear stress, while making the recirculation regions both smaller and weaker. The flow manipulators form a guide to divert and correct blood flow in critical regions of the aorta with anomalies.