• Pouya Youssefi, Rajan Sharma, C Alberto Figueroa, and Marjan Jahangiri.
• Department of Cardiothoracic Surgery & Cardiology, St. George's Hospital, St. George's University of London, Blackshaw Road, London, SW17 0QT, United Kingdom.
• Br. Med. Bull. 2017 Jan 1; 121 (1): 61-71.

IntroductionTreatment guidelines for the thoracic aorta concentrate on size, yet acute aortic dissection or rupture can occur when aortic size is below intervention criteria. Functional imaging and computational techniques are a means of assessing haemodynamic parameters involved in aortic pathology.Sources Of DataOriginal articles, reviews, international guidelines.Areas Of AgreementComputational fluid dynamics and 4D flow MRI allow non-invasive assessment of blood flow parameters and aortic wall biomechanics.Areas Of ControversyAortic valve morphology (particularly bicuspid aortic valve) is associated with aneurysm of the ascending aorta, although the exact mechanism of aneurysm formation is not yet established.Growing PointsHaemodynamic assessment of the thoracic aorta has highlighted parameters which are linked with both clinical outcome and protein changes in the aortic wall. Wall shear stress, flow displacement and helicity are elevated in patients with bicuspid aortic valve, particularly at locations of aneurysm formation.Areas Timely For Developing ResearchWith further validation, functional assessment of the aorta may help identify patients at risk of aortic complications, and introduce new haemodynamic indices into management guidelines.© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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