Analysis of pressure gradient across aortic stenosis with massively parallel computational simulations

Coarctation of the aorta (CoA) is one of the most common congenital heart defects in the United States, and despite treatment, patients have a decrease in life expectancy. Computational fluid dynamics simulations can provide the physician with a non-invasive method to measure the pressure gradient. With HARVEY, a massively parallel hemodynamics application, patient specific simulations can be conducted of large regions of the vasculature. The pressure across the stenosis is impacted by flow from nearby vessels. The purpose of this study was to study the impact of including these distal vessels in the simulation on the resulting pressure measurements. Computational fluid dynamic simulations were conducted in three subsets of one patient's vasculature. We demonstrate up to a 29% difference in calculated pressure gradient based on the number of vessels included in the simulation. These initial results are positive but need to be substantiated with further patient studies.