Ryan Pewowaruk, Luke Lamers, Alejandro Roldán-Alzate
University of Wisconsin.
United States
Annals of Biomedical Engineering
Ann Biomed Eng 2021; 49: 2365-2376
DOI: 10.1007/s10439-021-02780-5
Abstract
Branch pulmonary artery stenosis (PAS) commonly occurs in congenital heart disease and the pressure gradient over a stenotic PA lesion is an important marker for re-intervention. Image based computational fluid dynamics (CFD) has shown promise for non-invasively estimating pressure gradients but one limitation of CFD is long simulation times. The goal of this study was to compare accelerated predictions of PAS pressure gradients from 3D CFD with instantaneous adaptive mesh refinement (AMR) versus a recently developed 0D distributed lumped parameter CFD model. Predictions were then experimentally validated using a swine PAS model (n = 13). 3D CFD simulations with AMR improved efficiency by 5 times compared to fixed grid CFD simulations. 0D simulations further improved efficiency by 6 times compared to the 3D simulations with AMR. Both 0D and 3D simulations underestimated the pressure gradients measured by catheterization (- 1.87 ± 4.20 and – 1.78 ± 3.70 mmHg respectively). This was partially due to simulations neglecting the effects of a catheter in the stenosis. There was good agreement between 0D and 3D simulations (ICC 0.88 [0.66-0.96]) but only moderate agreement between simulations and experimental measurements (0D ICC 0.60 [0.11-0.86] and 3D ICC 0.66 [0.21-0.88]). Uncertainty assessment indicates that this was likely due to limited medical imaging resolution causing uncertainty in the segmented stenosis diameter in addition to uncertainty in the outlet resistances. This study showed that 0D lumped parameter models and 3D CFD with instantaneous AMR both improve the efficiency of hemodynamic modeling, but uncertainty from medical imaging resolution will limit the accuracy of pressure gradient estimations.
Category
Segmental Pulmonary Arterial Disease
Animal Models of Pulmonary Vascular Disease and Therapy
Mechanical and Computer Models of Pulmonary Vascular Disease and Therapy
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Diagnostic Testing for Pulmonary Vascular Disease. Invasive Testing
Age Focus: No Age-Related Focus
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes