Non-invasive hemodynamic assessment of aortic coarctation: validation with in vivo measurements

Lucian Itu1, Puneet Sharma, Kristóf Ralovich

  • 1Siemens Corporate Research and Technology, 755 College Road East, Princeton, NJ 08540, USA. lucian.itu@unitbv.ro

Insights

We developed a fast, automatic CFD method to assess blood flow in coarctation of the aorta (CoA) patients non-invasively. This approach accurately predicts pressure gradients, aiding pre- and post-operative care.

Area of Science:

  • Cardiovascular Physiology
  • Medical Imaging Analysis
  • Computational Fluid Dynamics

Background:

  • Coarctation of the aorta (CoA) requires careful hemodynamic assessment, especially pre- and post-operatively.
  • Current non-invasive methods may lack precision in determining pressure gradients across the coarctation.
  • Accurate hemodynamic assessment is crucial for effective patient management and surgical planning.

Purpose of the Study:

  • To introduce a novel, non-invasive computational fluid dynamics (CFD)-based approach for hemodynamic assessment in coarctation of the aorta (CoA) patients.
  • To determine the pressure gradient across the coarctation using patient-specific computational modeling.
  • To validate the feasibility and accuracy of this CFD approach in a clinical setting.

Main Methods:

  • Developed a reduced-order model for blood flow computation in patient-specific aortic geometries.
  • Implemented a parameter estimation procedure using non-invasive measurements for boundary and vessel wall conditions.
  • Integrated a comprehensive pressure-drop formulation with the reduced-order model for automatic calculation.
  • Validated the method against invasively measured peak pressure gradients in four CoA patient datasets.

Main Results:

  • The CFD-based algorithm is fully automatic, requiring no iterative tuning.
  • Computation time is approximately 6-8 minutes on a standard personal computer, ensuring clinical feasibility.
  • Preliminary validation showed a mean absolute error of less than 2 mmHg when compared to invasive measurements.
  • The approach demonstrated promising accuracy for pressure-drop computations in patients with native or recurrent coarctation.

Conclusions:

  • The proposed CFD-based approach offers a feasible and accurate non-invasive method for hemodynamic assessment in CoA patients.
  • This technique can reliably determine pressure gradients, supporting clinical decisions in pre- and post-operative management.
  • The automatic nature and short computation time make it suitable for routine clinical use.

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