In-vitro experimental investigation of the global hemodynamic effects of aortic coarctation on carotid and renal pulsatile blood flow

Aortic coarctation is the congenital constriction of the aorta, mainly affecting the proximal descending part of it. This condition significantly impacts the local pulsatile hemodynamics in the aorta. If left untreated, the mortality rate can reach 90% by the time individuals reach 50 years of age. However, the global effects of this condition on other organs, such as the brain and kidneys, are not fully understood. Clinical studies have shown that coarctation acts as a reflection site that affects pulsatile energy transmission and the volume blood flow to the brain and kidneys. However, the extent of this potentially harmful excessive pulsatile energy caused by coarctation toward these organs is not thoroughly studied. In this study, we use a physiologically accurate in-vitro experimental setup that simulates the hemodynamics of the coupled atrioventricular-aortic system. Hemodynamic measurements are performed for various cardiac outputs, heart rates, aortic compliances, and coarctation degrees. Pulsatile energy transmission, wave intensity, and power spectrum analysis are evaluated for the brain and kidneys to investigate the underlying physics of arterial waves in coarctation cases. This study reports the effects of the aforementioned parameters on cerebral and renal hemodynamics, providing a better understanding of the pulsatile hemodynamic changes in aortic coarctation patients. The outcome of this study can help design new patient-specific therapeutic approaches.