Patient-specific multiscale modeling of blood flow for coronary artery bypass graft surgery.
Patient-specific multiscale modeling of blood flow for coronary artery bypass graft surgery.
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DOI：
10.1007/s10439-012-0579-3
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发表时间：
2012-10
影响因子：
3.8
通讯作者：
Marsden, Alison L.
中科院分区：
文献类型：
--
作者：
Sankaran, Sethuraman;Moghadam, Mahdi Esmaily;Kahn, Andrew M.;Tseng, Elaine E.;Guccione, Julius M.;Marsden, Alison L.
我们提出了一个计算框架，用于冠状动脉旁路移植术（CABG）患者的多尺度建模和血流模拟。使用这个框架，只需要CT和非侵入性临床测量，而不需要假设冠状动脉的压力和/或流量波形，我们可以捕获全局循环动力学。我们在一个患有多个冠脉搭桥的患者的案例研究中证明了这种方法。根据CT图像数据构建患者特异性血管模型，包括主动脉、主动脉分支血管（头臂动脉和颈动脉）、冠状动脉和多个搭桥血管。循环系统的其余部分使用集总参数网络（LPN） 0维（0D）系统建模，该系统由电阻、电容器（顺应性）、电感器（惰性）、弹性和二极管（阀）组成，这些系统经过调整以匹配患者特定的临床数据。有限元求解器用于计算3D（3维）模型中的血流和压力，该求解器隐式耦合到所有入口和出口的0D LPN代码。通过系统地参数化移植物的几何形状，我们评估了移植物形状对局部血流动力学和整体循环动力学的影响。虚拟操作的嫁接几何是自动使用贝塞尔样条和控制点沿路径。利用这个框架，我们量化了不同手术几何形状的壁剪应力、壁剪应力梯度和振荡剪切指数。我们还比较了搭桥手术前后的压力、流速和心室压力-容积循环。我们观察到冠脉搭桥后PV袢没有明显变化，但吻合区附近的冠状动脉灌注和局部血流动力学参数发生了很大变化。讨论了对未来患者特异性冠脉搭桥优化的影响。
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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DOI：
10.1115/1.2895545
发表时间：
1993-11-01
影响因子：
1.7
作者：
GIDDENS, DP;ZARINS, CK;GLAGOV, S
通讯作者：
GLAGOV, S
影响因子：
2
作者：
Holzapfel, GA;Gasser, TC;Ogden, RW
通讯作者：
Ogden, RW
影响因子：
1.8
作者：
通讯作者：
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影响因子：
4.8
作者：
BOGREN, HG;KLIPSTEIN, RH;LONGMORE, DB
通讯作者：
LONGMORE, DB
DOI：
10.1007/s10047-003-0232-x
发表时间：
2003-01-01
期刊：
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs
影响因子：
--
作者：
Haruguchi, Hiroaki;Teraoka, Satoshi
通讯作者：
Teraoka, Satoshi