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Non-Invasive Hemodynamic Assessment of Aortic Coarctation: Validation with In Vivo Measurements

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Abstract

We propose a CFD-based approach for the non-invasive hemodynamic assessment of pre- and post-operative coarctation of aorta (CoA) patients. Under our approach, the pressure gradient across the coarctation is determined from computational modeling based on physiological principles, medical imaging data, and routine non-invasive clinical measurements. The main constituents of our approach are a reduced-order model for computing blood flow in patient-specific aortic geometries, a parameter estimation procedure for determining patient-specific boundary conditions and vessel wall parameters from non-invasive measurements, and a comprehensive pressure-drop formulation coupled with the overall reduced-order model. The proposed CFD-based algorithm is fully automatic, requiring no iterative tuning procedures for matching the computed results to observed patient data, and requires approximately 6–8 min of computation time on a standard personal computer (Intel Core2 Duo CPU, 3.06 GHz), thus making it feasible for use in a clinical setting. The initial validation studies for the pressure-drop computations have been performed on four patient datasets with native or recurrent coarctation, by comparing the results with the invasively measured peak pressure gradients recorded during routine cardiac catheterization procedure. The preliminary results are promising, with a mean absolute error of less than 2 mmHg in all the patients.

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Abbreviations

c :

Wave speed

C :

Windkessel compliance

DBP/SBP:

Diastolic/systolic blood pressure

E :

Young’s modulus

HR :

Heart rate

K v/K t/K u/K c :

Viscous/turbulent/inertance/continuous pressure-drop coefficient

L c :

Coarctation length

MAP:

Mean arterial pressure

Q asc/Q desc :

Flow rate through the ascending/descending aorta

Q CoA :

Flow rate through the coarctation

Q supra-aortic :

Flow rate through supra-aortic vessels

R c :

Coarctation resistance

R d/R p/R t :

Distal/proximal/total Windkessel resistance

Z:

Characteristic impedance

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Acknowledgments

The authors would like to acknowledge Dr. Michael Suehling and Dr. Constantin Suciu. This work was partially supported by the Sectorial Operational Programme Human Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian Government under the contract number POSDRU/88/1.5/S/76945. This work has been partially funded by European Union project Sim-e-Child (FP7 – 248421).

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Authors and Affiliations

  1. Siemens Corporate Research and Technology, 755 College Road East, Princeton, NJ, 08540, USA

    Lucian Itu, Puneet Sharma, Kristóf Ralovich, Viorel Mihalef, Razvan Ionasec, Ali Kamen & Dorin Comaniciu

  2. Transilvania University of Brasov, Str. Politehnicii nr. 1, Brasov, 500024, Romania

    Lucian Itu

  3. Technical University of Munich, Boltzmannstr. 3, Garching, 85748, Germany

    Kristóf Ralovich

  4. Pediatric Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Allen Everett & Richard Ringel

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  1. Lucian Itu
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  2. Puneet Sharma
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Correspondence to Lucian Itu.

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Associate Editor Scott L. Diamond oversaw the review of this article.

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Itu, L., Sharma, P., Ralovich, K. et al. Non-Invasive Hemodynamic Assessment of Aortic Coarctation: Validation with In Vivo Measurements. Ann Biomed Eng 41, 669–681 (2013). https://doi.org/10.1007/s10439-012-0715-0

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