Anomalous aortic origin of coronary arteries (AAOCA) is a congenital disease that can lead to cardiac ischemia during intense physical activity. Although AAOCA is responsible for sudden cardiac death (SCD) among young athletes and soldiers, the mechanisms underlying the coronary occlusion during physical effort still have to be clarified. The present study investigates the correlation between geometric features of the anomaly and coronary lumen narrowing under aortic root dilatations. Idealized parametric computer-aided designed (CAD) models of the aortic root with anomalous and normal coronaries are created and static finite element (FE) simulations of increasing aortic root expansions are carried out. Different coronary take-off angles and intramural penetrations are investigated to assess their role on coronary lumen narrowing. Results show that increasing aortic and coronary pressures lead to lumen expansion in normal coronaries, particularly in the proximal tract, while the expansion of the anomalous coronaries is impaired especially at the ostium. Concerning the geometric features of the anomaly, acute take-off angles cause elongated coronary ostia, with an eccentricity increasing with aortic expansion; the impact of the coronary intramural penetration on the lumen narrowing is limited. The present study provides a proof of concept of the biomechanical reasons underlying the lumen narrowing in AAOCA during aortic expansion, promoting the role of computational simulations as a tool to assess the mechanisms of this pathology.
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November 2018
Research-Article
Aortic Expansion Induces Lumen Narrowing in Anomalous Coronary Arteries: A Parametric Structural Finite Element Analysis
Giovanni Maria Formato,
Giovanni Maria Formato
Department of Civil Engineering and
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: giovannimaria.formato01@universitadipavia.it
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: giovannimaria.formato01@universitadipavia.it
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Mauro Lo Rito,
Mauro Lo Rito
IRCCS Policlinico San Donato,
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: mauro.lorito@gmail.com
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: mauro.lorito@gmail.com
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Ferdinando Auricchio,
Ferdinando Auricchio
Department of Civil Engineering and
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: auricchio@unipv.it
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: auricchio@unipv.it
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Alessandro Frigiola,
Alessandro Frigiola
IRCCS Policlinico San Donato,
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: alessandro.frigiola@grupposandonato.it
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: alessandro.frigiola@grupposandonato.it
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Michele Conti
Michele Conti
Department of Civil Engineering and
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: michele.conti@unipv.it
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: michele.conti@unipv.it
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Giovanni Maria Formato
Department of Civil Engineering and
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: giovannimaria.formato01@universitadipavia.it
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: giovannimaria.formato01@universitadipavia.it
Mauro Lo Rito
IRCCS Policlinico San Donato,
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: mauro.lorito@gmail.com
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: mauro.lorito@gmail.com
Ferdinando Auricchio
Department of Civil Engineering and
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: auricchio@unipv.it
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: auricchio@unipv.it
Alessandro Frigiola
IRCCS Policlinico San Donato,
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: alessandro.frigiola@grupposandonato.it
Department of Congenital Cardiac Surgery,
San Donato Milanese 20097, Italy
e-mail: alessandro.frigiola@grupposandonato.it
Michele Conti
Department of Civil Engineering and
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: michele.conti@unipv.it
Architecture (DICAr),
University of Pavia,
Pavia 27100, Italy
e-mail: michele.conti@unipv.it
Manuscript received February 13, 2018; final manuscript received July 16, 2018; published online August 20, 2018. Assoc. Editor: Giuseppe Vairo.
J Biomech Eng. Nov 2018, 140(11): 111008 (9 pages)
Published Online: August 20, 2018
Article history
Received:
February 13, 2018
Revised:
July 16, 2018
Citation
Formato, G. M., Lo Rito, M., Auricchio, F., Frigiola, A., and Conti, M. (August 20, 2018). "Aortic Expansion Induces Lumen Narrowing in Anomalous Coronary Arteries: A Parametric Structural Finite Element Analysis." ASME. J Biomech Eng. November 2018; 140(11): 111008. https://doi.org/10.1115/1.4040941
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