How CARDIOPROOF helps in the decision making process: a Concrete Clinical Scenario

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At the German heart institute in Berlin, clinicians face many situations in clinical everyday practice in which the decision-making process is not always straightforward. This is the case of a six years old boy, who we had in cure, with a combined disease of bicuspid aortic valve and coarctation of the aorta. He came to us after having undergone already two balloon angioplasties in the past. He wasn’t taking medication and presented arterial hypertension. When measuring his blood pressure around both arms and both legs we found a gradient of 11mmHg, and by ECG examination we found a gradient of 43 mmHg: these are very high values compared to normal blood pressure values In the MRI scans we detected that there were two situations wherethe narrowing of the aorta took place.That circumstance put us in front of two choices: place a stent or not in these two locations? Where to exactly place it?

nsl-8Thanks to the CARDIOPROOF models and simulation tools, we have now not only the chance to detect the diameter alterations in a three-dimensional way, but also to simulate the flow across the entire vessel. Thanks to those simulations, we can see the alterations and turbulences in the flow that originates from his bicuspid aortic valve. Additionally, we have a chance to look at the centre line diameter of the vessel and simulate where the stenosis actually originates. Finally, the specific tool for Virtual stenting simulations, based on the patient individual geometries, can tell us the haemodynamic outcome after the stenting procedure, prior to proceeding to the real intervention, thus allowing us to understand whether the intervention would help or not the patient.

We can conclude that such tools can really help the clinician in his decision making process!

by Marcus Kelm, Deutsche Herzzentrum Berlin

For more information, see  “Newsletters- ISSUE 2