Patient-specific Modelling and Simulation of Coronary Haemodynamics

摘要

The field of coronary artery disease is primarily concerned with the impairment of coronary haemodynamics. All the therapeutic measures that are performed (pharmacotherapy, bypass surgery, balloon angioplasty/stents) are designed to increase the supply of blood to the myocardium. An effective and efficient way to achieve a further improvement in the quality of care would be by designing a computer system that enabled clinicians to quantitatively assess the coronary haemodynamics of individual patients and quantitatively predict the improvements that could be achieved with different therapeutic (revascularisation) measures. We aim at the development of such a computer system for use in clinical settings. It will be based on patient-specific simulation models that are derived from information contained in medical images (biplane angiograms, perfusion images, and other functional images). In particular, we developed lumped parameter models of the coronary haemodynamics which permit simulation studies of the supply of blood to the myocardium and its impairment that results from pathological changes. However, to be able to assess other specific pathophysiological processes, such as thrombus development and stenoses growth, cardiologists need a precise knowledge of the local three-dimensional flow pattern in stenosed sections of the coronary artery tree. We have thus expanded our simulation efforts to include into the system additional facilities for a genuine three-dimensional simulation of the irregular blood flow patterns in the region of stenoses. A GRID solution has been chosen for the implementation that makes use of the infrastructure of the AUSTRIAN GRID Initiative, which is funded by the Austrian Federal Government.