Fluid-structure interaction simulations for the prediction of fractional flow reserve in pediatric patients with anomalous aortic origin of a coronary artery
arxiv(2024)
摘要
Computer simulations of blood flow in patients with anomalous aortic origin
of a coronary artery (AAOCA) have the promise to provide insight into this
complex disease. They provide an in-silico experimental platform to explore
possible mechanisms of myocardial ischemia, a potentially deadly complication
for patients with this defect. This paper focuses on the question of model
calibration for fluid-structure interaction models of pediatric AAOCA patients.
Imaging and cardiac catheterization data provide partial information for model
construction and calibration. However, parameters for downstream boundary
conditions needed for these models are difficult to estimate. Further,
important model predictions, like fractional flow reserve (FFR), are sensitive
to these parameters. We describe an approach to calibrate downstream boundary
condition parameters to clinical measurements of resting FFR. The calibrated
models are then used to predict FFR at stress, an invasively measured quantity
that can be used in the clinical evaluation of these patients. We find
reasonable agreement between the model predicted and clinically measured FFR at
stress, indicating the credibility of this modeling framework for predicting
hemodynamics of pediatric AAOCA patients. This approach could lead to important
clinical applications since it may serve as a tool for risk stratifying
children with AAOCA.
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