Numerical and experimental assessment of turbulent kinetic energy in an aortic coarctation.

The turbulent blood flow through an aortic coarctation in a 63-year old female patient was studied experimentally using magnetic resonance imaging (MRI), and numerically using computational fluid dynamics (CFD), before and after catheter intervention. Turbulent kinetic energy (TKE) was computed in the numerical model using large eddy simulation and compared with direct in vivo MRI measurements. Despite the two totally different methods to obtain TKE values, both quantitative and qualitative results agreed very well. The results showed that even though both blood flow rate and Reynolds number increased after intervention, total turbulent kinetic energy levels decreased in the coarctation. Therefore, the use of the Reynolds number alone as a measure of turbulence in cardiovascular flows should be used with caution. Furthermore, the change in flow field and kinetic energy were assessed, and it was found that before intervention a jet formed in the throat of the coarctation, which impacted the arterial wall just downstream the constriction. After intervention the jet was significantly weaker and broke up almost immediately, presumably resulting in less stress on the wall. As there was a good agreement between measurements and numerical results (the increase and decrease of integrated TKE matched measurements almost perfectly while peak values differed by approximately 1mJ), the CFD results confirmed the MRI measurements while at the same time providing high-resolution details about the flow. Thus, this preliminary study indicates that MR-based TKE measurements might be useful as a diagnostic tool when evaluating intervention outcome, while the detailed numerical results might be useful for further understanding of the flow for treatment planning.