Thoracic aortic pathologies, such as aortic aneurysms and aortic dissections, are slow-progressing yet highly fatal cardiovascular diseases with a near 100% mortality rate upon rupture. Thoracic endovascular aortic repair (TEVAR) has emerged as an effective, minimally invasive treatment that reduces post-operative complications and optimizes patient outcomes. Yet, TEVAR is highly susceptible to the complex, patient-specific anatomical and biomechanical environments, which pose a wide variety of potential device-related risks (e.g. endoleaks, migration, collapse) to be addressed with discretion. As such, advancements computational fluid dynamics (CFD) enable the simulation of blood flow numerically, hence facilitating the qualitative and quantitative investigation of the haemodynamics and their impact on the device.

Fetal aortic stenosis (AS) with evolving hypoplastic left heart syndrome (feHLHS) causes high risks of progression to HLHS at birth. An in-utero catheter-based intervention, Fetal Aortic Valvuloplasty (FAV), has shown promise as an intervention strategy to circumvent the progression, but its impact on the heart's biomechanics is not well understood. We performed patient-specific computational fluid dynamic (CFD) simulations based on 4D fetal echocardiography to assess the changes in the fluid mechanical environment in the feHLHS left ventricle (LV) before and after FAV.