Results:
Patient 1 demonstrated restoration of cohesive flow and resolution of
the large systolic vortex previously present in the aneurysmal portion
of her AAo (Figure 1). Patient 2 also showed a cohesive flow pattern in
the AAo with some complex flow in the arch. Compared to the control,
there was qualitatively less helical flow in patients with HAART ring.
Flow at the level of the HAART ring was uniform in both patients. In
patient 1, peak velocities were increased in the aortic root and all
levels of the arch, but slightly decreased in the proximal and mid AAo
following surgery (Figure 2). The highest velocities occurred just
distal to the HAART ring in patient 1 (1.59 m/s) and in patient 2 (2.82
m/s). Peak velocities in the control patient increased along her entire
aorta post-operatively except for at the proximal AAo, where it
decreased from 1.53 to 1.24 m/s. The peak velocity gradient across the
HAART ring, captured at planes just above in the root and below in the
LVOT, was negligible in patient 1 (-0.02 m/s), while in patient 2 there
was a 0.34 m/s increase in velocity. In the control patient there was a
0.3 m/s increase.
Compared to levels before surgery, there was marginally lower WSS in the
AAo and arch in patient 1 after HAART as determined by the mean value of
aortic surface with the highest 5% of WSS levels (0.902 and 0.894 Pa),
but higher overall mean WSS in the AAo and arch (0.298 and 0.403 Pa).
The matched control had a marked increase in WSS after surgery and
greater post-surgery levels of WSS overall than patient 1 (0.629 and
1.163 Pa). Post-surgery WSS in patient 2 was elevated in comparison to
both patient 1 and the control (1.995 Pa), with peak WSS occurring in
the native aortic root (Figure 3).
Patient 1 demonstrated higher levels of VEL in the AAo and arch after
surgery (23.3 and 3.3 W/m3 vs 56.6 and 13.1
W/m3); however, the post-surgery energy loss in
patient 1 was both lower overall and increased to a lesser extent than
in the control after surgery (23.4 and 5.0 W/m3 vs
73.2 and 30.2 W/m3). Patient 2 showed modestly greater
energy loss in the AAo but less in the arch compared to the control
(109.0 and 25.3 W/m3). All patients presented in this
report had no aorta related complications and trace to no AI or AS on
echocardiogram following surgery.