Circulation, Vol 88, 2235-2247, Copyright © 1993 by American Heart Association
PJ Kilner, GZ Yang, RH Mohiaddin, DN Firmin and DB Longmore
BACKGROUND. Helical and retrograde secondary flows have been recorded in
the aorta, but their origins and movements in relation to the arch have not
been clarified. We set out to do this using magnetic resonance velocity
mapping. METHODS AND RESULTS. Three-directional phase contrast cine
magnetic resonance velocity mapping was used to map multidirectional flow
velocities in the aortas of 10 healthy volunteers. Computer processing was
used to visualize flow vector patterns in selected planes. Right-handed
helical flows predominated in the upper aortic arch in late systole, being
clearly recognizable in 9 of the 10 subjects. Nonaxial components of
velocity in this region reached 0.29 m/s (+/- 0.05 m/s) as axial velocities
declined from a peak of 1.0 m/s (+/- 0.1 m/s). Helical flow patterns in the
upper descending aorta varied between subjects, apparently depending on
arch curvature. End-systolic retrograde flow originated from regions of
blood with low momentum, usually along inner wall curvatures. Flow studies
in a curved tubular phantom showed right-handed helical flow in the upper
"arch" when the inflow section was positioned to simulate ascending aortic
curvature, and retrograde flow occurred along the inner wall at end systole
during pulsatile flow. CONCLUSIONS. Helical and retrograde streams are
consistent features of intra-aortic flow in healthy subjects that result,
at least in part, from the curvature of the arch and the pulsatility of
flow in it. They may have significance in relation to circulatory dynamics
and the pathogenesis of atheroma in the arch.
ARTICLES
Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping
Royal Brompton National Heart and Lung Hospital, London, UK.
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