A fast virtual surgery platform for many scenarios haemodynamics of patient-specific coronary artery bypass grafts

A fast computational framework is devised to the study of several configurations of patient-specific coronary artery bypass grafts. This is especially useful to perform a sensitivity analysis of the haemodynamics for different flow conditions occurring in native coronary arteries and bypass grafts, the investigation of the progression of the coronary artery disF. Ballarin MOX Modeling and Scientific Computing, Dipartimento di Matematica, Politecnico di Milano, P.za Leonardo da Vinci 32, I-20133 Milano, Italy. Current address: mathLab, Mathematics Area, SISSA, via Bonomea 265, I-34136 Trieste, Italy. E-mail: francesco.ballarin@sissa.it E. Faggiano MOX Modeling and Scientific Computing, Dipartimento di Matematica, Politecnico di Milano, P.za Leonardo da Vinci 32, I-20133 Milano, Italy. Current address: Computational Mechanics & Advanced Materials Group, Department of Civil Engineering and Architecture, University of Pavia, via Ferrata 3, I-27100 Pavia, Italy A. Manzoni CMCS Modelling and Scientific Computing, Ecole Polytechnique Fédérale de Lausanne, Station 8, CH-1015 Lausanne, Switzerland G. Rozza mathLab, Mathematics Area, SISSA, via Bonomea 265, I-34136 Trieste, Italy A. Quarteroni CMCS Modelling and Scientific Computing, Ecole Polytechnique Fédérale de Lausanne, Station 8, CH-1015 Lausanne, Switzerland S. Ippolito Radiology Unit, Ospedale Luigi Sacco, Via G. B. Grassi 74, I-20157 Milano, Italy C. Antona Cardiovascular Surgery Unit, Ospedale Luigi Sacco, Via G. B. Grassi 74, I-20157 Milano, Italy. R. Scrofani Cardiovascular Surgery Unit, Ospedale Luigi Sacco, Via G. B. Grassi 74, I-20157 Milano, Italy. ease and the choice of the most appropriate surgical procedure. A complete pipeline, from the acquisition of patientspecific medical images to fast parametrized computational simulations, is proposed. Complex surgical configurations employed in the clinical practice, such as Y-grafts and sequential grafts, are studied. A virtual surgery platform based on model reduction of unsteady Navier Stokes equations for blood dynamics is proposed to carry out sensitivity analyses in a very rapid and reliable way. A specialized geometrical parametrization is employed to compare the effect of stenosis and anastomosis variation on the outcome of the surgery in several relevant cases.

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