Abstract
Cardiovascular disease has been the major cause of death worldwide. Although the initiation and progression mechanism of the atherosclerosis are similar, the stenotic characteristics and the corresponding medical decisions are different between individuals. In the present study, we performed anatomic and hemodynamic analysis on 8 left coronary arterial trees with 10 identified stenoses. A novel boundary condition method had been implemented for fast computational fluid dynamics simulations and patient-specific three-dimensional printed models had been built for visualizations. Our results suggested that the multiple spatial characteristics (curvature of the culprit vessel multiplied by an angle of the culprit’s vessel to the upstream parent branch) could be an index of hemodynamics significance (r = −0.673, P-value = 0.033). and reduction of the maximum velocity from stenosis to downstream was found correlated to the FFRCT (r = 0.480, p = 0.160). In addition, 3D printed models could provide accurate replicas of the patient-specific left coronary arterial trees compare to virtual 3D models (r = 0.987, P-value < 0.001). Therefore, the visualization of the 3D printed models could help understand the spatial distribution of the stenoses and the hand-held experience could potentially benefit the educating and preparing of medical strategies.
Highlights
Cardiovascular disease (CVD) is the leading cause of death globally regardless of sex that responding to approximately 30% of the mortality according to the Centers for Disease Control and Prevention (CDC) and World Health Organization[1,2]
The hemodynamics analysis illustrated flow distribution variations due to the complex plaques for the assessment of the severity, but the visualization of the pathological arterial segments is limited in computer screens[18,19] that make it difficult to assist in the preparation of the surgery planning without further invasive examination, such as the preparation of the stent before having Invasive coronary angiography (ICA)
The distance of the stenosis from the ostium of the coronary artery was significantly positively correlated with the severity of stenosis (r = 0.624, P-value = 0.027)
Summary
Cardiovascular disease (CVD) is the leading cause of death globally regardless of sex that responding to approximately 30% of the mortality according to the Centers for Disease Control and Prevention (CDC) and World Health Organization[1,2]. Previous studies have proved the diagnostic accuracy of computed tomography angiography (CTA) for identifying severity of the stenosis and the capability for predicting acute coronary symptoms[6,7,8], but the frequent overestimation of the hemodynamic significance causes excessive burden to the patient without obstructive CVD including economic www.nature.com/scientificreports/. The hemodynamics analysis illustrated flow distribution variations due to the complex plaques for the assessment of the severity, but the visualization of the pathological arterial segments is limited in computer screens[18,19] that make it difficult to assist in the preparation of the surgery planning without further invasive examination, such as the preparation of the stent before having Invasive coronary angiography (ICA). Three-dimensional printing was applied in developing the hand-held model, in addition to the hemodynamics analysis by computational fluid dynamics(CFD) to provide a visual identification of the correlation between spatial characteristics and the hemodynamics in the culprit’s vessels
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