Computer-Aided Patient-Specific Coronary Artery Graft Design Improvements Using CFD Coupled Shape Optimizer

Onur Dur, Sinan Tolga Coskun, Kasim Oguz Coskun, David Frakes, Levent Burak Kara, Kerem Pekkan

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

This study aims to (i) demonstrate the efficacy of a new surgical planning framework for complex cardiovascular reconstructions, (ii) develop a computational fluid dynamics (CFD) coupled multi-dimensional shape optimization method to aid patient-specific coronary artery by-pass graft (CABG) design and, (iii) compare the hemodynamic efficiency of the sequential CABG, i. e., raising a daughter parallel branch from the parent CABG in patient-specific 3D settings. Hemodynamic efficiency of patient-specific complete revascularization scenarios for right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCX) bypasses were investigated in comparison to the stenosis condition. Multivariate 2D constraint optimization was applied on the left internal mammary artery (LIMA) graft, which was parameterized based on actual surgical settings extracted from 2D CT slices. The objective function was set to minimize the local variation of wall shear stress (WSS) and other hemodynamic indices (energy dissipation, flow deviation angle, average WSS, and vorticity) that correlate with performance of the graft and risk of re-stenosis at the anastomosis zone. Once the optimized 2D graft shape was obtained, it was translated to 3D using an in-house "sketch-based" interactive anatomical editing tool. The final graft design was evaluated using an experimentally validated second-order non-Newtonian CFD solver incorporating resistance based outlet boundary conditions. 3D patient-specific simulations for the healthy coronary anatomy produced realistic coronary flows. All revascularization techniques restored coronary perfusions to the healthy baseline. Multi-scale evaluation of the optimized LIMA graft enabled significant wall shear stress gradient (WSSG) relief (~34%). In comparison to original LIMA graft, sequential graft also lowered the WSSG by 15% proximal to LAD and diagonal bifurcation. The proposed sketch-based surgical planning paradigm evaluated the selected coronary bypass surgery procedures based on acute hemodynamic readjustments of aorta-CA flow. This methodology may provide a rational to aid surgical decision making in time-critical, patient-specific CA bypass operations before in vivo execution.

Original languageEnglish (US)
Pages (from-to)35-47
Number of pages13
JournalCardiovascular Engineering and Technology
Volume2
Issue number1
DOIs
StatePublished - Mar 2011

Fingerprint

Hydrodynamics
Grafts
Coronary Vessels
Computational fluid dynamics
Transplants
Hemodynamics
Mammary Arteries
Shear stress
Arteries
Pathologic Constriction
Patient Simulation
Planning
Shape optimization
Vorticity
Nuclear Family
Surgery
Aorta
Energy dissipation
Anatomy
Decision Making

Keywords

  • Bypass graft
  • CFD
  • Coronary artery
  • Hemodynamics
  • Sequential graft
  • Shape optimization
  • Surgical design
  • Surgical planning
  • WSS
  • WSSG

ASJC Scopus subject areas

  • Biomedical Engineering
  • Cardiology and Cardiovascular Medicine

Cite this

Computer-Aided Patient-Specific Coronary Artery Graft Design Improvements Using CFD Coupled Shape Optimizer. / Dur, Onur; Coskun, Sinan Tolga; Coskun, Kasim Oguz; Frakes, David; Kara, Levent Burak; Pekkan, Kerem.

In: Cardiovascular Engineering and Technology, Vol. 2, No. 1, 03.2011, p. 35-47.

Research output: Contribution to journalArticle

Dur, Onur ; Coskun, Sinan Tolga ; Coskun, Kasim Oguz ; Frakes, David ; Kara, Levent Burak ; Pekkan, Kerem. / Computer-Aided Patient-Specific Coronary Artery Graft Design Improvements Using CFD Coupled Shape Optimizer. In: Cardiovascular Engineering and Technology. 2011 ; Vol. 2, No. 1. pp. 35-47.
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