Demonstrations of Medical CFD

Non-Invasive Assessment of Coronary Artery Disease Using FFRCT 

Coronary artery disease (CAD) is characterized by the narrowing of coronary arteries due to atherosclerotic plaque accumulation. Traditionally, the severity of a coronary stenosis is assessed using Fractional Flow Reserve (FFR), an invasive procedure requiring catheterization and pressure measurements within the coronary arteries.

Computational Fluid Dynamics has enabled the development of CT-derived Fractional Flow Reserve (FFRCT), in which patient-specific coronary artery geometries are reconstructed from coronary CT angiography and used to simulate blood flow. CFD algorithms calculate pressure changes throughout the coronary network, allowing clinicians to estimate FFR without invasive intervention.

Clinical studies have demonstrated a strong correlation between CFD-derived FFRCT and invasive FFR measurements. This approach provides detailed hemodynamic information regarding pressure losses across stenotic lesions and can help identify which blockages are likely to impair myocardial perfusion. As a result, FFRCT has become one of the most successful examples of CFD translation into routine cardiovascular diagnostics.

The use of CFD-based FFR assessment has reduced the need for unnecessary invasive angiography while improving diagnostic confidence in patients with suspected coronary artery disease. The clinical importance of FFRCT and patient-specific coronary flow simulation is well documented in the literature and continues to expand as computational methods become faster and more automated.

CFD-Guided Surgical Planning for Fontan Circulation 

Patients born with single-ventricle congenital heart defects often require a series of surgical procedures culminating in a Fontan operation. In this procedure, venous blood is redirected directly to the pulmonary arteries without passing through a functional right ventricle.

Because blood flow pathways vary significantly between patients, predicting postoperative hemodynamics can be challenging. Researchers have therefore developed patient-specific CFD models that reconstruct cardiovascular anatomy from medical imaging data and simulate blood flow under various surgical configurations.

In one reported case, computational simulations were used to evaluate multiple Fontan surgical designs before intervention. CFD analysis quantified energy losses, flow distribution to the lungs, and pressure gradients throughout the circulation. The simulations identified surgical configurations that minimized power loss and improved pulmonary blood flow distribution.

These findings demonstrated that CFD can function as a virtual testing environment, allowing surgeons to compare alternative procedures before entering the operating room. Such approaches represent a significant step toward personalized cardiovascular medicine and patient-specific surgical planning. Multiple studies have demonstrated the feasibility of CFD-assisted Fontan planning and optimization, showing that computationally designed pathways can outperform actual postoperative configurations in terms of hemodynamic efficiency. 

Transcatheter Aortic Valve Replacement (TAVR) Planning 

Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure used to treat severe aortic valve stenosis. Although highly effective, the procedure carries risks including coronary artery obstruction, conduction abnormalities, and improper valve positioning.

Researchers have increasingly employed CFD and patient-specific simulation techniques to evaluate procedural outcomes before intervention. In one documented case, pre-procedural computational modeling was used to investigate implantation strategies and assess the risk of coronary obstruction following valve deployment.

The simulation predicted how blood flow would interact with the implanted valve and surrounding anatomy, allowing clinicians to evaluate alternative implantation approaches. The resulting analysis helped identify a strategy that minimized the likelihood of obstructing coronary blood flow while maintaining effective valve performance.

CFD can provide valuable hemodynamic insights that are difficult to obtain through imaging alone. By enabling virtual testing of treatment options, computational modeling has the potential to improve procedural safety and support individualized treatment planning. Patient-specific simulations have been successfully applied to TAVR planning, including studies focused on valve positioning, coronary obstruction risk, and procedural optimization 

References

Frieberg, P., Aristokleous, N., Sjöberg, P., Töger, J., Liuba, P., & Carlsson, M. (2022). Computational Fluid Dynamics Support for Fontan Planning in Minutes, Not Hours: The Next Step in Clinical Pre-Interventional Simulations. Journal of cardiovascular translational research, 15(4), 708–720. https://doi.org/10.1007/s12265-021-10198-6  

Mori, S, Aksoy, O, Do, D. et al. Transcatheter Aortic Valve Replacement Guided by Preprocedural Simulation of Fluoroscopic Location of the Membranous Septum. J Am Coll Cardiol Case Rep. 2023 Jun, 16 (null) .

Nair, S. S., Gopalakrishnan, A., Ayyappan, A., Baruah, S. D., Dharan, B. S., & Sreedharan, S. (2025). Computational fluid dynamics-driven optimization of Fontan surgery from patient-specific data: A pilot study. Annals of pediatric cardiology, 18(4), 357–364. https://doi.org/10.4103/apc.apc_78_25 

Vanderlaan, R, Di Nardo, A, Amon, C. A Multidisciplinary Approach to Patient-Specific Surgical Planning in Congenital Heart Disease. JACC Adv. 2024 Jul, 3 (7_Part_1) .