Patient-Specific CFD Simulation for CABG Graft Hemodynamics
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Solution Overview
Problem
Current methods for assessing the hemodynamic significance of coronary artery stenoses in coronary artery bypass grafting (CABG) are invasive, prone to variability, and do not accurately predict graft patency, particularly for vein grafts, due to reliance on angiographic interpretations and fractional flow reserve (FFR) measurements that are time-consuming and risky.
Innovation Solution
A computational simulation platform using non-invasive imaging and computational fluid dynamics (CFD) to generate patient-specific 3D reconstructions of the heart and coronary arteries, allowing for virtual CABG simulations under resting and hyperemic conditions to assess the hemodynamic impact of bypass grafts, employing models like the Windkessel and lumped parameter models to simulate flow and resistance.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If invasive wire-based FFR measurement is used to assess hemodynamic significance, then measurement precision is improved, but device complexity and procedural risk increase
Solution Approach 1:
The patent creates a virtual copy of the patient's coronary anatomy through 3D reconstruction from non-invasive imaging data. This digital twin allows for computational simulation of FFR measurements without requiring physical wire insertion, thereby maintaining measurement precision while eliminating procedural complexity and risk
Solution Approach 2:
The patent replaces the mechanical wire-based measurement system with a computational fluid dynamics simulation system. Instead of physically inserting a pressure wire into the coronary arteries, the system uses CFD algorithms to simulate blood flow and calculate FFR values from non-invasive imaging data, eliminating the need for invasive mechanical intervention
2Measurement precision
If invasive wire-based FFR measurement is used to assess hemodynamic significance, then measurement precision is improved, but loss of time increases
Solution Approach 1:
The patent performs 3D reconstruction and CFD model setup using non-invasive imaging data acquired before the procedure. By preparing the computational model in advance with patient-specific anatomy, the system enables rapid FFR assessment during the procedure without requiring time-consuming wire manipulation and hyperemic induction
3Ease of operation
If angiographic interpretation is used to assess coronary stenosis, then ease of operation is improved, but measurement precision deteriorates
Solution Approach 1:
The patent replaces subjective visual interpretation with objective computational fluid dynamics simulation. Instead of relying on operator experience to visually assess stenosis severity, the system uses CFD algorithms to calculate actual hemodynamic parameters including pressure drops and FFR values, providing precise quantitative assessment that is independent of observer variability
Solution Approach 2:
The patent transforms the assessment from qualitative visual interpretation to quantitative hemodynamic parameter measurement. By calculating FFR values, pressure gradients, and flow rates through CFD simulation, the system provides objective numerical data that accurately reflects the physiological impact of stenosis rather than relying on visual estimation
4Ease of manufacture
If vein grafts are used in CABG, then ease of manufacture is improved, but reliability deteriorates due to neointimalhyperplasia
Solution Approach 1:
The patent performs preoperative CFD simulation to predict post-CABG hemodynamics for different graft configurations. By evaluating flow distribution, wall shear stress, and pressure gradients in the virtual model, surgeons can select optimal graft types and anastomosis locations before surgery, potentially preventing conditions that lead to neointimalhyperplasia and graft failure
Solution Approach 2:
The patent provides hemodynamic feedback through CFD simulation results that show how different graft configurations affect blood flow patterns. This feedback allows optimization of graft selection and surgical planning to achieve hemodynamic conditions that minimize the risk of neointimalhyperplasia and maximize long-term graft patency
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enables accurate, non-invasive prediction of post-CABG hemodynamics, allowing surgeons to tailor surgical plans for improved graft patency and outcomes by simulating the effects of different graft types and configurations on native coronary arteries and bypass grafts.
Implementation Method 1
performing post-virtual CABG computational fluid dynamic (CFD) studies under computational resting and stress conditions
Implementation Method 2
employing models like the Windkessel and lumped parameter models to simulate flow and resistance
Data Source
AI summary
In accordance with embodiments of this disclosure, a computational simulation platform for assessing impact of coronary artery bypass grafting comprises a computer-implemented method that includes: generating patient-specific three-dimensional (3D) reconstructions of path lines for a patient's heart, ascending aorta, aortic arch, descending thoracic aorta, great vessels, coronary arteries and their major branches based on noninvasive imaging; performing virtual CABG by modifying the patient-specific 3D reconstructions to computationally add path lines for one or more bypass grafts; performing post-virtual CABG computational fluid dynamic (CFD) studies under computational resting and stress conditions; and assessing hemodynamic impact of virtual CABG on the resting and hyperemic flow of diseased native coronary arteries and virtual bypass grafts.