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Flow Characteristics by Blood Speckle Imaging in Non-Stenotic Congenital Aortic Root Disease Surrounding Valve-Preserving Operations
KTH, School of Engineering Sciences (SCI), Mathematics (Dept.), Numerical Analysis, Optimization and Systems Theory.
Congenital Valve Procedural Planning Program, Department of Pediatric Cardiology and Division of Pediatric Cardiac Surgery, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Congenital Valve Procedural Planning Program, Department of Pediatric Cardiology and Division of Pediatric Cardiac Surgery, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, 44195, USA.
Department of Pediatric Cardiology, Cleveland Clinic, Cleveland, OH, 44195, USA.
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2025 (English)In: Bioengineering, E-ISSN 2306-5354, Vol. 12, no 7, article id 776Article in journal (Refereed) Published
Abstract [en]

Contemporary evaluation and surgical approaches in congenital aortic valve disease have yielded limited success. The ability to evaluate and understand detailed flow characteristics surrounding surgical repair may be beneficial. This study explores the feasibility and utility of echocardiographic-based blood speckle imaging (BSI) in assessing pre- and post-operative flow characteristics in those with non-stenotic congenital aortic root disease undergoing aortic valve repair or valve-sparing root replacement (VSRR) surgery. Transesophageal echocardiogram was performed during the pre-operative and post-operative assessment surrounding aortic surgery for ten patients with non-stenotic congenital aortic root disease. BSI, utilizing block-matching algorithms, enabled detailed visualization and quantification of flow parameters from the echocardiographic data. Post-operative BSI unveiled enhanced hemodynamic patterns, characterized by quantified changes suggestive of the absence of stenosis and no more than trivial regurgitation. Rectification of an asymmetric jet and the reversal of flow on the posterior aspect of the ascending aorta resulted in a reduced oscillatory shear index ((Formula presented.)) of (Formula presented.) (pre-op) vs. (Formula presented.) (post-op) and (Formula presented.), increased peak wall shear stress of (Formula presented.) (pre-op) vs. (Formula presented.) (post-op) and (Formula presented.), and increased time-averaged wall shear stress of (Formula presented.) (pre-op) vs. (Formula presented.) (post-op) and (Formula presented.). This correction potentially attenuates cellular alterations within the endothelium. This study demonstrates that children and young adults with non-stenotic congenital aortic root disease undergoing valve-preserving operations experience significant improvements in flow dynamics within the left ventricular outflow tract and aortic root, accompanied by a reduction in (Formula presented.). These hemodynamic enhancements extend beyond the conventional echocardiographic assessments, offering immediate and valuable insights into the efficacy of surgical interventions.

Place, publisher, year, edition, pages
MDPI AG , 2025. Vol. 12, no 7, article id 776
Keywords [en]
aortic regurgitation, aortic valve repair, aortic valve-sparing root replacement, blood speckle imaging, congenital heart disease, hemodynamics
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:kth:diva-368582DOI: 10.3390/bioengineering12070776ISI: 001535434600001PubMedID: 40722468Scopus ID: 2-s2.0-105011725549OAI: oai:DiVA.org:kth-368582DiVA, id: diva2:1990484
Note

QC 20250820

Available from: 2025-08-20 Created: 2025-08-20 Last updated: 2025-11-13Bibliographically approved

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Liu, ShihaoRyan, Jennifer K.Sundström, Elias

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