Numerical biomechanics modelling of indirect mitral annuloplasty treatments for functional mitral regurgitation

Mitral valve regurgitation (MR) is a common valvular heart disease where an improper closure leads to leakage from the left ventricle into the left atrium. There is a need for less-invasive treatments such as percutaneous repairs for a large inoperable patient population. The aim of this study is to compare several indirect mitral annuloplasty (IMA) percutaneous repair techniques by finite-element analyses. Two types of generic IMA devices were considered, based on coronary sinus vein shortening (IMA-CS) to reduce the annulus perimeter and based on shortening of the anterior–posterior diameter (IMA-AP). The disease, its treatments, and the heart function post-repair were modelled by modifying the living heart human model (Dassault Systèmes). A functional MR pathology that represents ischaemic MR was generated and the IMA treatments were simulated in it, followed by heart function simulations with the devices and leakage quantification from blood flow simulations. All treatments were able to reduce leakage, the IMA-AP device achieved better sealing, and there was a correlation between the IMA-CS device length and the reduction in leakage. The results of this study can help in bringing IMA-AP to market, expanding the use of IMA devices, and optimizing future designs of such devices.

A machine-learning-based method for automatizing lattice-Boltzmann simulations of respiratory flows

Many simulation workflows require to prepare the data for the simulation manually. This is time consuming and leads to a massive bottleneck when a large number of numerical simulations is requested. This bottleneck can be overcome by an automated data processing pipeline. Such a novel pipeline is developed for a medical use case from rhinology, where computer tomography recordings are used as input and flow simulation data define the results. Convolutional neural networks are applied to segment the upper airways and to detect and prepare the in- and outflow regions for accurate boundary condition prescription in the simulation. The automated process is tested on three cases which have not been used to train the networks. The accuracy of the pipeline is evaluated by comparing the network-generated output surfaces to those obtained from a semi-automated procedure performed by a medical professional. Except for minor deviations at interfaces between ethmoidal sinuses, the network-generated surface is sufficiently accurate. To further analyze the accuracy of the automated pipeline, flow simulations are conducted with a thermal lattice-Boltzmann method for both cases on a high-performace computing system. The comparison of the results of the respiratory flow simulations yield averaged errors of less than 1% for the pressure loss between the in- and outlets, and for the outlet temperature. Thus, the pipeline is shown to work accurately and the geometrical deviations at the ethmoidal sinuses to be negligible.

Distance and Rotational Speed Analysis of Coaxial Rotors for UTHM C-Drone

The prototype of UTHM C-Drone use a coaxial hexacopter concept for its propulsion system. A coaxial rotor consists of two motor and two propellers mounted above each other and aligned in relation to their axis of rotation. The propellers are based on the T-Motor U15XXL KV29 model used in UTHM C-Drone. The distance between the two propellers is usually relative to the radius of the propeller or can be lesser. The objectives for this study are to investigate the effect of distance between upper and lower propeller in a coaxial rotors system and the effect of rotational speed. This study is important to ensure the C-Drone power efficient and capable to lift 180 kg payload. The CAD model of the propeller and coaxial rotors system were designed based on the specification from T-Motor company by Solidworks software and the flow simulations were conducted using Solidworks Flow Simulation module. The total of six CAD models; one for a single propeller and five for coaxial rotors with five difference of distance cases were constructed. For each model, the total thrust was tested from 50% throttle power up to the 90% throttle power. It was found that the coaxial rotors system can generate more thrust than a single propeller but less than double. It was also found that if the lower propeller rotates faster than the upper propeller, the increment of total thrust is very small. However, if the upper propeller rotates faster than the lower propeller, the total thrust increase significantly. For the case of faster upper propeller, as the higher the throttle applied, the thrust increment ratio will decrease, and the efficiency of the thrust produced will be affected. In addition, for same rotation speed, the thrust generated was lesser when both propellers rotate in a same direction compared to when each propeller rotates in the opposite directions of each other.

Toward noninvasive assessment of stroke risk in pediatric cerebrovascular disease

Background and Purpose: Moyamoya disease (MMD) is a progressive steno-occlusive cerebrovascular disease leading to recurrent stroke. There is a lack of reliable biomarkers to identify unilateral stroke MMD patients who are likely to progress to bilateral disease and experience subsequent contralateral stroke(s). We hypothesized that local hemodynamics are predictive of future stroke and set out to noninvasively assess this stroke risk in pediatric MMD patients. Methods: MR and X-ray angiography imaging were utilized to reconstruct patient-specific models of the circle of Willis of 6 pediatric MMD patients who had previous strokes, along with a control subject. Blood flow simulations were performed by using a Navier-Stokes solver within an isogeometric analysis framework. Vascular regions with a wall shear rate (WSR) above the coagulation limit (> 5000 s-1) were identified to have a higher probability of thrombus formation, potentially leading to ischemic stroke(s). Two metrics, namely, ″critical WSR coverage″ and ″WSR score″, were derived to assess contralateral stroke risk and compared with clinical follow-up data. Results: In two patients that suffered a contralateral stroke within two months of the primary stroke, critical WSR coverages exceeding 50% of vessel surface and WSR scores greater than 6x the control were present in multiple contralateral vessels. These metrics were not as conclusive in two additional patients with 3-to-5-year gaps between primary and contralateral strokes. However, a longitudinal study of one of these two cases, where a subsequent timepoint was analyzed, accurately predicted disease stabilization on the primary stroke side and an elevated contralateral stroke risk, thus indicating that post-stroke follow-up at regular intervals might be warranted for secondary stroke prevention. Conclusions: WSR-based metrics could be predictive of future stroke risk after an initial stroke in MMD patients. In addition, more accurate predictions may be possible by performing patient-specific hemodynamic analysis at multiple timepoints during patient follow-up to monitor changes in the WSR-based metrics.