Key result
The 3D/0D computational fluid dynamics model estimated blood pressure drop with an absolute error of 10 ± 8 mmHg compared to invasive catheter measurements at the coarctation site.
Why the study?
The study explored implementing a non-invasive workflow using routinely collected medical imaging and clinical measurements to provide detailed insight into local aortic haemodynamics to support clinical decision-making.
Does multi-scale CFD-based modeling accurately estimate trans-coarctation pressure gradients compared to invasive catheterization in patients with aortic coarctation?
Observational (n=11)
No
Does multi-scale CFD-based modeling accurately estimate trans-coarctation pressure gradients compared to invasive catheterization in patients with aortic coarctation?
A multi-scale CFD approach for non-invasive assessment of aortic coarctation showed an absolute error of 10 ± 8 mmHg compared to invasive catheterization, indicating a need for further model refinement.
Noninvasive 3D/0D CFD modeling yields moderate agreement with catheterization; leaves open further refinement before clinical adoption in aortic coarctation.
We present a multi-scale CFD-based study conducted in a cohort of 11 patients with coarctation of the aorta (CoA). The study explores the potential for implementation of a workflow using non-invasive routinely collected medical imaging data and clinical measurements to provide a more detailed insight into local aortic haemodynamics in order to support clinical decision making. Our approach is multi-scale, using a reduced-order model (1D/0D) and an optimization process for the personalization of patient-specific boundary conditions and aortic vessel wall parameters from non-invasive measurements, to inform a more complex model (3D/0D) representing 3D aortic patient-specific anatomy. The reliability of the modelling approach is investigated by comparing 3D/0D model pressure drop estimation with measured peak gradients recorded during diagnostic cardiac catheterization and 2D PC-MRI flow rate measurements in the descending aorta. The current study demonstrated that the proposed approach requires low levels of user interaction, making it suitable for the clinical setting. The agreement between computed blood pressure drop and catheter measurements is 10 ± 8 mmHg at the coarctation site. The comparison between CFD derived and catheter measured pressure gradients indicated that the model has to be improved, suggesting the use of time varying pressure waveforms to further optimize the tuning process and modelling assumptions.
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Mercuri et al. (2020) conducted an observational in Aortic coarctation (n=11). 3D/0D computational fluid dynamics (CFD) model vs. Invasive cardiac catheterization was evaluated on Absolute error in pressure drop at the coarctation site. The 3D/0D computational fluid dynamics model estimated blood pressure drop with an absolute error of 10 ± 8 mmHg compared to invasive catheter measurements at the coarctation site.
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