Coronary artery problems constitute a delicate matter. Traditionally, interventional cardiologists use percutaneous treatment to cut and remove arterial plaque, but they often experience severe difficulties in predicting the final outcome of the operation. Additionally, the assessment of the specialised equipment is still based on crude models of the coronary arterial tree. In order to refine the process of coronary revascularisation, the Medical Simulation Group at the Institute of Systems Science (ISS) in Singapore has a plan to develop a computable hemodynamic model which will assist in the pre-treatment planning of complex cases by means of realistic simulation in virtual reality.
The ISS has organised this three-year research-and-development project in collaboration with an expert staff in the Cardiac Laboratory at Tan Tock Seng Hospital (TTSH). Once the hemodynamic model has been created, it can be integrated in an Interventional Cardiology Simulator, referred to as ICard, for simulated interaction between the specific conditions of arterial disease and the surgical devices, such as catheters, guidewire, balloons, stents, and so on. In this way, the team hopes to provide an objective method to evaluate the specialised equipment, as to possibly improve the new generation of devices.
The hemodynamic model might also be helpful to list and assess the various responses of atherosclerotic or restenotic lesions to treatment with balloon angioplasty or other tools, and atherectomy. The researchers will try to obtain useful results by computing deformations of the coronary arteries as well as fluid dynamics, such as pressure, velocity and temperature, of the blood flow in the concerned arteries. A second set of data which has to be taken in account, constitutes the morphology, geometry and material properties of the plaque or of the otherwise affected arteries. Surgical actions like catheter and guidewire navigation; angioplasty balloon inflation; stent placement; and plaque cutting and removal will be analysed through Finite Element Method (FEM) and Computational Fluid Dynamics (CFD) coding.
Thus, the team will obtain an accurate virtual environment in which it will be possible to simulate and assess realistic percutaneous coronary revascularisation procedures. Ultimately, patients will benefit from improved and more secure treatment and the design and testing of medical devices will be optimised for the future. The Institute of Systems Science is very active in the field of medical simulation. Please, check in at the Medical Simutation Group's web site to learn more about its different projects.