Customised healthcare to predict outcomes in cardiovascular surgery

Ms Selene Pirola from Imperial College London
Selene Pirola, Department of Chemical Engineering

Article by Selene Pirola and Chloe Armour.

Selene Pirola, Research Assistant in the Department of Chemical Engineering at Imperial College London, is researching the fluid dynamics of blood with the aim of being able to better predict outcomes of cardiovascular surgery. Specifically, her most recent research looks at the impact of blood flow and pressure in patients treated for aortic dissection.

The aorta is the biggest and most important blood vessel of the human body. An aortic dissection is a life-threatening clinical emergency where blood begins to leak from the aorta due to a tear in the vessel lining. This prevents a portion of blood reaching, and delivering oxygen to, the body’s organs and can result in the vessel rupturing. This type of incident is known as aortic dissection, and it can prove fatal.

Aortic dissection can be treated with a minimally-invasive procedure, where the affected area is covered with a stent, in a similar way as a plaster would cover a cut in the skin. However, it can be difficult to tell how successful an operation will be before it is carried out.

In research published in IEEE Transaction on Biomedical Engineering, Ms Pirola used patient’s data in the form of medical images to create computer simulations which can be used to predict how a patient’s blood flow will have an impact on their surgery. Understanding the characteristics of blood flow, or hemodynamics, is vitally important to understand the development of this type of vascular disease. Blood flow features have been connected to the development of cardiovascular illness and play a key role in determining the outcome of surgical and endovascular procedures.

Recent developments have allowed for medical images to be used for more than diagnostic purposes, such as analysing pressure and flow data. However, such data is not highly utilised during the treatment phase in the hospital at the moment. This new method presented by Ms Pirola would allow surgeons to measure pre-operative pressure and flow data to evaluate how it will be affected post-surgery in a specific patient. It is also cost-effective, as it aims to use data which is already acquired as part of the pre-operation assessment.

In the long term it is hoped that this research will allow surgeons to provide patient-specific predictions for surgical outcomes, as well as aiding device improvement and development, for example by improving pre-surgical planning.

It is part of wider research efforts of the Biofluids and Transport Group (Xu Group) at Imperial College London to better understand this type of aortic condition and improve treatment. The long-term aim of the group would be to combine all their work in this area, which examines the problem from different angles. PhD student Chloe Armour is studying the flow features in aortic dissection and working on the optimisation of a flow model created by former group member Dr Claudia Menichini, which can predict thrombus formation in dissection. In addition to aortic dissection, the group is working on various other vascular diseases, with PhD student Emily Manchester focusing on turbulent hemodynamics in the aorta, and Dr Boram Gu modelling one method for treating a stroke which can be caused by a blood clot in the arteries leading to the brain.

Xu Group from Imperial College London
Xu Group from Imperial College London

You can follow Xu Group on Twitter @XuGroupICL or find out more about their work on their website.

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