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Patient-Specific Multiscale Modeling of Blood Flow for Coronary Artery Bypass Graft Surgery

Overview of attention for article published in Annals of Biomedical Engineering, April 2012
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Title
Patient-Specific Multiscale Modeling of Blood Flow for Coronary Artery Bypass Graft Surgery
Published in
Annals of Biomedical Engineering, April 2012
DOI 10.1007/s10439-012-0579-3
Pubmed ID
Authors

Sethuraman Sankaran, Mahdi Esmaily Moghadam, Andrew M. Kahn, Elaine E. Tseng, Julius M. Guccione, Alison L. Marsden

Abstract

We present a computational framework for multiscale modeling and simulation of blood flow in coronary artery bypass graft (CABG) patients. Using this framework, only CT and non-invasive clinical measurements are required without the need to assume pressure and/or flow waveforms in the coronaries and we can capture global circulatory dynamics. We demonstrate this methodology in a case study of a patient with multiple CABGs. A patient-specific model of the blood vessels is constructed from CT image data to include the aorta, aortic branch vessels (brachiocephalic artery and carotids), the coronary arteries and multiple bypass grafts. The rest of the circulatory system is modeled using a lumped parameter network (LPN) 0 dimensional (0D) system comprised of resistances, capacitors (compliance), inductors (inertance), elastance and diodes (valves) that are tuned to match patient-specific clinical data. A finite element solver is used to compute blood flow and pressure in the 3D (3 dimensional) model, and this solver is implicitly coupled to the 0D LPN code at all inlets and outlets. By systematically parameterizing the graft geometry, we evaluate the influence of graft shape on the local hemodynamics, and global circulatory dynamics. Virtual manipulation of graft geometry is automated using Bezier splines and control points along the pathlines. Using this framework, we quantify wall shear stress, wall shear stress gradients and oscillatory shear index for different surgical geometries. We also compare pressures, flow rates and ventricular pressure-volume loops pre- and post-bypass graft surgery. We observe that PV loops do not change significantly after CABG but that both coronary perfusion and local hemodynamic parameters near the anastomosis region change substantially. Implications for future patient-specific optimization of CABG are discussed.

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Geographical breakdown

Country Count As %
United States 3 1%
Israel 1 <1%
Brazil 1 <1%
United Kingdom 1 <1%
India 1 <1%
Unknown 220 97%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 51 22%
Researcher 31 14%
Student > Master 31 14%
Student > Bachelor 14 6%
Professor > Associate Professor 11 5%
Other 38 17%
Unknown 51 22%
Readers by discipline Count As %
Engineering 107 47%
Medicine and Dentistry 20 9%
Computer Science 11 5%
Mathematics 8 4%
Agricultural and Biological Sciences 4 2%
Other 15 7%
Unknown 62 27%