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March 3, 2023SHILAP Revista de lepidopterologíaOpen Access

Patient-specific computational simulation of coronary artery bypass grafting

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Key result

Patient-specific computational CABG simulation accurately models hemodynamics with high agreement to angiographic FFR.

  • n=2

Comparison

Hemodynamic conditions before vs after CABG

Design

Patient-specific computational simulation study

Authors

WWWei WuAPAnastasios PanagopoulosCVCharu Hasini Vasa

Discussion

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Overview

Enables virtual CABG planning in select cases; leaves open clinical utility pending prospective validation.

Structured PICO

P
Population
2 post-CABG patients whose coronary anatomies were 3D reconstructed from computed tomography angiography to computationally simulate hemodynamics before and after bypass grafting.
I
Intervention
Computational simulation of coronary artery bypass grafting (CABG)
O
Outcome
Hemodynamic conditions and effects of bypass grafting on native coronary artery flowsurrogate

A novel patient-specific computational platform successfully simulates the hemodynamic effects of CABG, providing a foundation for future clinical validation.

Limitations

  • Pre-CABG models were based on post-CABG CCTA by computationally removing bypass grafts due to lack of pre-CABG CCTA
  • Tested computational FFR against angiographic FFR instead of the invasive FFR gold standard
  • Tested on a limited number of patients (n=2)
  • Focused only on LIMA grafting of the LAD
  • Pre-existent native epicardial coronary artery disease could confound the effects of computationally added stenoses
  • Used aortic flow rates and ventricular pressures from healthy individuals rather than individual study patients
  • Used an open-loop model with the same lumped parameters in pre- and post-CABG simulations
  • Vascular wall was considered rigid in simulations
  • Preliminary data requiring further clinical studies for validation

Cite This Study

Wu et al. (2023) studied Coronary artery disease (n=2). Computational simulation of CABG vs. Pre-CABG anatomy was evaluated on Agreement between computational fractional flow reserve (FFR) and angiographic FFR. A patient-specific computational platform successfully simulated hemodynamic conditions before and after CABG, showing high agreement with angiographic fractional flow reserve.

synapsesocial.com/papers/69dff07eb28b234044e9be86https://doi.org/10.1371/journal.pone.0281423
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A computational fluid–structure interaction analysis of coronary Y-grafts2017 · 25 citations
  2. 2Coronary artery bypass grafting hemodynamics and anastomosis design: a biomedical engineering review2013 · 135 citations
  3. 3The Hemodynamic Mechanism of FFR-Guided Coronary Artery Bypass Grafting2021 · 15 citations
  4. 4Computational Fluid Dynamics Applied to Cardiac Computed Tomography for Noninvasive Quantification of Fractional Flow Reserve2013 · 1,217 citations
  5. 5Role of Endothelial Shear Stress in the Natural History of Coronary Atherosclerosis and Vascular Remodeling2007 · 1,476 citations