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The Effects That Cardiac Motion has on Coronary Hemodynamics and Catheter Trackability Forces for the Treatment of Coronary Artery Disease: An In Vitro Assessment

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Abstract

The coronary arterial tree experiences large displacements due to the contraction and expansion of the cardiac muscle and may influence coronary haemodynamics and stent placement. The accurate measurement of catheter trackability forces within physiological relevant test systems is required for optimum catheter design. The effects of cardiac motion on coronary flowrates, pressure drops, and stent delivery has not been previously experimentally assessed. A cardiac simulator was designed and manufactured which replicates physiological coronary flowrates and cardiac motion within a patient-specific geometry. A motorized delivery system delivered a commercially available coronary stent system and monitored the trackability forces along three phantom patient-specific thin walled compliant coronary vessels supported by a dynamic cardiac phantom model. Pressure drop variation is more sensitive to cardiac motion than outlet flowrates. Maximum pressure drops varied from 7 to 49 mmHg for a stenosis % area reduction of 56 to 90%. There was a strong positive linear correlation of cumulative trackability force with the cumulative curvature. The maximum trackability forces and curvature ranged from 0.24 to 0.87 N and 0.06 to 0.22 mm−1 respectively for all three vessels. There were maximum and average percentage differences in trackability forces of (23–49%) and (1.9–5.2%) respectively when comparing a static pressure case with the inclusion of pulsatile flow and cardiac motion. Cardiac motion with pulsatile flow significantly altered (p value <0.001) the trackability forces along the delivery pathways with high local percentage variations and pressure drop measurements.

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Acknowledgments

The authors would like to acknowledge Strands I and III funding from the Department of Education in Ireland and IRCSET funding from the Irish Research Council.

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The authors declare that they have no conflict of interest.

Human and Animal Studies

No human or animal studies were carried out by the authors for this article.

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Authors and Affiliations

  1. Galway Medical Technologies Centre, Department of Mechanical and Industrial Engineering, Galway Mayo Institute of Technology, Galway, Ireland

    Liam Morris, Paul Fahy, Florian Stefanov & Ronan Finn

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  1. Liam Morris
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  2. Paul Fahy
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Correspondence to Liam Morris.

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Associate Editor Ajit P. Yoganathan oversaw the review of this article.

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Morris, L., Fahy, P., Stefanov, F. et al. The Effects That Cardiac Motion has on Coronary Hemodynamics and Catheter Trackability Forces for the Treatment of Coronary Artery Disease: An In Vitro Assessment. Cardiovasc Eng Tech 6, 430–449 (2015). https://doi.org/10.1007/s13239-015-0241-y

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