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Published on: June 3, 2018
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Patient-specific computational models to support interventional procedures: a case study of complex aortic
Daria Cosentino1, Claudio Capelli, Graham Derrick
1UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, London, United Kingdom.
Summary
Patient-specific computational models successfully planned re-stenting for complex aortic re-coarctation (rCoA) with an aberrant right subclavian artery, guiding stent selection for optimal outcomes.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Medical Imaging
Background:
- Complex aortic re-coarctation (rCoA) presents significant treatment challenges, particularly in patients with prior interventions like bare metal stenting.
- Aberrant right subclavian artery adds complexity to rCoA repair, requiring careful consideration of blood flow dynamics.
Observation:
- Patient-specific computational models were developed using clinical imaging data (CT, echocardiography, MRI).
- Finite element (FE) and computational fluid dynamics (CFD) analyses simulated stent deployment and hemodynamic effects.
- Preoperative flow measurements informed CFD analysis for assessing pressure relief and subclavian artery perfusion.
Findings:
- FE simulations determined an optimal CP covered stent expansion diameter of 16-18 mm for relieving rCoA, covering the aneurysm, and ensuring adequate right subclavian artery flow.
- CFD analysis validated the chosen stent diameter's ability to manage pressure gradients and maintain perfusion.
- A 16 mm CP covered stent was successfully implanted based on the computational modeling predictions.
Implications:
- Patient-specific computational modeling offers a powerful tool for planning complex cardiovascular interventions like rCoA re-stenting.
- Integrating computational techniques into clinical practice can improve patient management and treatment outcomes for challenging aortic pathologies.
- This approach demonstrates the potential for personalized medicine in treating congenital heart defects and acquired aortic diseases.
