CFD as Non-Invasive Tool for Patient- Specific Treatment Support in Cardiology

Transcription

1 CFD as Non-Invasive Tool for Patient- Specific Treatment Support in Cardiology Katharina Vellguth U N I V E R S I T Ä T S M E D I Z I N B E R L I N

2 Introduction [1] 2

3 Introduction Heart valve surgeries per year in Germany 30% recurrence rate of mitral valve repair surgeries high level of suffering for affected people 3

4 Introduction Mitral valve diseases Stenosis Insufficiency reduced blood flow through valve during ventricular filling phase regurgitation through mitral valve during ventricular contraction 4

5 Introduction Mitral valve diseases Stenosis Insufficiency Shortness of breath Hypertension Racing heart beat [2] 5

6 Introduction Therapy Repair Replacement MitraClip Mechanical or Biological valve [3] [4] Annulus reconstruction [5] 6

7 Introduction Therapy Repair Replacement MitraClip [3] Mechanical or Biolocigal valve Mechanical: Thrombus formation Annulus reconstruction [5] Biological: [4] Short durability 7

8 Introduction Therapy Repair Replacement MitraClip Annulus reconstruction [3] 30% recurrence rate! [5] Mechanical or Biolocigal valve Mechanical: Thrombus formation Biological: [4] Short durability 8

9 Idea and Objective CFD [6] [7] treatment planning support 9

10 Requirements for CFD model Time saving Robust Easily adaptable reproduction of clinical parameters 10

11 Patient specific data acquisition - Imaging CT-acquisition during diastole (with open mitral valve) Segmentation Surface generation 11

12 Patient specific data acquisition Pressure inlet Wall Boundary condition for ventricle wall? 12

13 Comparison of two models At moment of maximum blood flow through valve 1) Morphed walls 2) Porous medium Velocity outlet Wall Grid velocity 13

14 Comparison of two models At moment of maximum blood flow through valve 1) Morphed walls 2) Porous medium 14

15 Comparison of two models At moment of maximum blood flow through valve 1) Morphed walls 2) Porous medium CONTINUUM 3D Laminar Implicit unsteady Constant density MESH Polyhedral mesh Prism layer 15

16 Comparison of total CPU solver time solid lines morphing dashed lines porous 16

17 Comparison of velocity field morphing porous t = 10ms t = 20ms t = 30ms 17

18 Comparison of velocity field morphing t = 10ms t = 20ms t = 30ms porous 18

19 Comparison of pressure drop over valve 19

20 Conclusion Porous model 8 times faster than morphing Velocity fields similar Pressure drop more stable in porous model No problems with cell quality in porous model Promising model for simulation of short time frame 20

21 Outlook 21

22 Outlook Yet to do Validation using clinical data Application on ventricular contraction phase Admission as medical product 22

23 Thank you for your attention! 23

24 Image sources [1] [2] climbinghttp://premiumejuice.com/i-can-climb-the-stairs/color [3] [4] [5] / index.htm [6] [7] 24