scholarly journals Virtual surgeries in patients with congenital heart disease: a multi-scale modelling test case

2011 ◽  
Vol 369 (1954) ◽  
pp. 4316-4330 ◽  
Author(s):  
A. Baretta ◽  
C. Corsini ◽  
W. Yang ◽  
I. E. Vignon-Clementel ◽  
A. L. Marsden ◽  
...  
Keyword(s):  
Boundary Conditions ◽  
Congenital Heart ◽  
Closed Loop ◽  
Three Dimensional ◽  
Scale Model ◽  
Patient Specific ◽  
Loop Model ◽  
Multi Scale ◽  
Venae Cavae ◽  
Lumped Parameter

The objective of this work is to perform a virtual planning of surgical repairs in patients with congenital heart diseases—to test the predictive capability of a closed-loop multi-scale model. As a first step, we reproduced the pre-operative state of a specific patient with a univentricular circulation and a bidirectional cavopulmonary anastomosis (BCPA), starting from the patient's clinical data. Namely, by adopting a closed-loop multi-scale approach, the boundary conditions at the inlet and outlet sections of the three-dimensional model were automatically calculated by a lumped parameter network. Successively, we simulated three alternative surgical designs of the total cavopulmonary connection (TCPC). In particular, a T-junction of the venae cavae to the pulmonary arteries (T-TCPC), a design with an offset between the venae cavae (O-TCPC) and a Y-graft design (Y-TCPC) were compared. A multi-scale closed-loop model consisting of a lumped parameter network representing the whole circulation and a patient-specific three-dimensional finite volume model of the BCPA with detailed pulmonary anatomy was built. The three TCPC alternatives were investigated in terms of energetics and haemodynamics. Effects of exercise were also investigated. Results showed that the pre-operative caval flows should not be used as boundary conditions in post-operative simulations owing to changes in the flow waveforms post-operatively. The multi-scale approach is a possible solution to overcome this incongruence. Power losses of the Y-TCPC were lower than all other TCPC models both at rest and under exercise conditions and it distributed the inferior vena cava flow evenly to both lungs. Further work is needed to correlate results from these simulations with clinical outcomes.

scholarly journals Boundary conditions of patient-specific fluid dynamics modelling of cavopulmonary connections: possible adaptation of pulmonary resistances results in a critical issue for a virtual surgical planning

2011 ◽  
Vol 1 (3) ◽  
pp. 297-307 ◽  
Author(s):  
Giancarlo Pennati ◽  
Chiara Corsini ◽  
Daria Cosentino ◽  
Tain-Yen Hsia ◽  
Vincenzo S. Luisi ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Boundary Conditions ◽  
Three Dimensional ◽  
Critical Issue ◽  
Patient Specific ◽  
Imaging Data ◽  
Venae Cavae ◽  
Cavopulmonary Anastomosis ◽  
Operative Planning ◽  
The Right

Cavopulmonary connections are surgical procedures used to treat a variety of complex congenital cardiac defects. Virtual pre-operative planning based on in silico patient-specific modelling might become a powerful tool in the surgical decision-making process. For this purpose, three-dimensional models can be easily developed from medical imaging data to investigate individual haemodynamics. However, the definition of patient-specific boundary conditions is still a crucial issue. The present study describes an approach to evaluate the vascular impedance of the right and left lungs on the basis of pre-operative clinical data and numerical simulations. Computational fluid dynamics techniques are applied to a patient with a bidirectional cavopulmonary anastomosis, who later underwent a total cavopulmonary connection (TCPC). Multi-scale models describing the surgical region and the lungs are adopted, while the flow rates measured in the venae cavae are used at the model inlets. Pre-operative and post-operative conditions are investigated; namely, TCPC haemodynamics, which are predicted using patient-specific pre-operative boundary conditions, indicates that the pre-operative balanced lung resistances are not compatible with the TCPC measured flows, suggesting that the pulmonary vascular impedances changed individually after the surgery. These modifications might be the consequence of adaptation to the altered pulmonary blood flows.

scholarly journals Electro-Mechanical Whole-Heart Digital Twins: A Fully Coupled Multi-Physics Approach

Mathematics ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1247
Author(s):  
Tobias Gerach ◽  
Steffen Schuler ◽  
Jonathan Fröhlich ◽  
Laura Lindner ◽  
Ekaterina Kovacheva ◽  
...  
Keyword(s):  
Human Heart ◽  
Clinical Decision Making ◽  
Scale Model ◽  
Patient Specific ◽  
Loop Model ◽  
Multi Scale ◽  
Atrial Ablation ◽  
Digital Twins ◽  
Whole Heart ◽  
Fully Coupled

Mathematical models of the human heart are evolving to become a cornerstone of precision medicine and support clinical decision making by providing a powerful tool to understand the mechanisms underlying pathophysiological conditions. In this study, we present a detailed mathematical description of a fully coupled multi-scale model of the human heart, including electrophysiology, mechanics, and a closed-loop model of circulation. State-of-the-art models based on human physiology are used to describe membrane kinetics, excitation-contraction coupling and active tension generation in the atria and the ventricles. Furthermore, we highlight ways to adapt this framework to patient specific measurements to build digital twins. The validity of the model is demonstrated through simulations on a personalized whole heart geometry based on magnetic resonance imaging data of a healthy volunteer. Additionally, the fully coupled model was employed to evaluate the effects of a typical atrial ablation scar on the cardiovascular system. With this work, we provide an adaptable multi-scale model that allows a comprehensive personalization from ion channels to the organ level enabling digital twin modeling.

Three-dimensional Reconstruction of Microscopic Image Based on Multi-ST Algorithm

2020 ◽  
Vol 64 (2) ◽  
pp. 20506-1-20506-7
Author(s):  
Min Zhu ◽  
Rongfu Zhang ◽  
Pei Ma ◽  
Xuedian Zhang ◽  
Qi Guo
Keyword(s):  
3D Reconstruction ◽  
Three Dimensional ◽  
Scale Model ◽  
Microscopic Image ◽  
Multi Scale ◽  
Gaussian Pyramid ◽  
Cost Aggregation ◽  
Dimensional Reconstruction ◽  
Image Pairs ◽  
Accurate Matching

Abstract Three-dimensional (3D) reconstruction is extensively used in microscopic applications. Reducing excessive error points and achieving accurate matching of weak texture regions have been the classical challenges for 3D microscopic vision. A Multi-ST algorithm was proposed to improve matching accuracy. The process is performed in two main stages: scaled microscopic images and regularized cost aggregation. First, microscopic image pairs with different scales were extracted according to the Gaussian pyramid criterion. Second, a novel cost aggregation approach based on the regularized multi-scale model was implemented into all scales to obtain the final cost. To evaluate the performances of the proposed Multi-ST algorithm and compare different algorithms, seven groups of images from the Middlebury dataset and four groups of experimental images obtained by a binocular microscopic system were analyzed. Disparity maps and reconstruction maps generated by the proposed approach contained more information and fewer outliers or artifacts. Furthermore, 3D reconstruction of the plug gauges using the Multi-ST algorithm showed that the error was less than 0.025 mm.

scholarly journals A flexible framework for sequential estimation of model parameters in computational hemodynamics

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Christopher J. Arthurs ◽  
Nan Xiao ◽  
Philippe Moireau ◽  
Tobias Schaeffter ◽  
C. Alberto Figueroa
Keyword(s):  
Unscented Kalman Filter ◽  
Three Dimensional ◽  
Synthetic Data ◽  
Sequential Estimation ◽  
Wall Material ◽  
Patient Specific ◽  
Model Parameters ◽  
Computational Framework ◽  
Lumped Parameter ◽  
Estimation Of Model Parameters

AbstractA major challenge in constructing three dimensional patient specific hemodynamic models is the calibration of model parameters to match patient data on flow, pressure, wall motion, etc. acquired in the clinic. Current workflows are manual and time-consuming. This work presents a flexible computational framework for model parameter estimation in cardiovascular flows that relies on the following fundamental contributions. (i) A Reduced-Order Unscented Kalman Filter (ROUKF) model for data assimilation for wall material and simple lumped parameter network (LPN) boundary condition model parameters. (ii) A constrained least squares augmentation (ROUKF-CLS) for more complex LPNs. (iii) A “Netlist” implementation, supporting easy filtering of parameters in such complex LPNs. The ROUKF algorithm is demonstrated using non-invasive patient-specific data on anatomy, flow and pressure from a healthy volunteer. The ROUKF-CLS algorithm is demonstrated using synthetic data on a coronary LPN. The methods described in this paper have been implemented as part of the CRIMSON hemodynamics software package.

scholarly journals Impact of Inflow Boundary Conditions on the Calculation of CT-Based FFR

Fluids ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. 60 ◽  
Author(s):  
Ernest Lo ◽  
Leon Menezes ◽  
Ryo Torii
Keyword(s):  
Boundary Conditions ◽  
Coronary Arteries ◽  
Three Dimensional ◽  
Patient Specific ◽  
Fractional Flow ◽  
Anatomical Models ◽  
Diastolic Phase ◽  
Flow Reserve ◽  
Population Average ◽  
The Impact

Background: Calculation of fractional flow reserve (FFR) using computed tomography (CT)-based 3D anatomical models and computational fluid dynamics (CFD) has become a common method to non-invasively assess the functional severity of atherosclerotic narrowing in coronary arteries. We examined the impact of various inflow boundary conditions on computation of FFR to shed light on the requirements for inflow boundary conditions to ensure model representation. Methods: Three-dimensional anatomical models of coronary arteries for four patients with mild to severe stenosis were reconstructed from CT images. FFR and its commonly-used alternatives were derived using the models and CFD. A combination of four types of inflow boundary conditions (BC) was employed: pulsatile, steady, patient-specific and population average. Results: The maximum difference of FFR between pulsatile and steady inflow conditions was 0.02 (2.4%), approximately at a level similar to a reported uncertainty level of clinical FFR measurement (3–4%). The flow with steady BC appeared to represent well the diastolic phase of pulsatile flow, where FFR is measured. Though the difference between patient-specific and population average BCs affected the flow more, the maximum discrepancy of FFR was 0.07 (8.3%), despite the patient-specific inflow of one patient being nearly twice as the population average. Conclusions: In the patients investigated, the type of inflow boundary condition, especially flow pulsatility, does not have a significant impact on computed FFRs in narrowed coronary arteries.

scholarly journals Personalized Three-Dimensional Printed Models in Congenital Heart Disease

2019 ◽  
Vol 8 (4) ◽  
pp. 522 ◽  
Author(s):  
Sun ◽  
Lau ◽  
Wong ◽  
Yeong
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Patient Specific ◽  
Future Research ◽  
Imaging Data ◽  
Doctor Patient Communication ◽  
Medical Education And Training ◽  
3D Printed

Patient-specific three-dimensional (3D) printed models have been increasingly used in cardiology and cardiac surgery, in particular, showing great value in the domain of congenital heart disease (CHD). CHD is characterized by complex cardiac anomalies with disease variations between individuals; thus, it is difficult to obtain comprehensive spatial conceptualization of the cardiac structures based on the current imaging visualizations. 3D printed models derived from patient’s cardiac imaging data overcome this limitation by creating personalized 3D heart models, which not only improve spatial visualization, but also assist preoperative planning and simulation of cardiac procedures, serve as a useful tool in medical education and training, and improve doctor–patient communication. This review article provides an overall view of the clinical applications and usefulness of 3D printed models in CHD. Current limitations and future research directions of 3D printed heart models are highlighted.

scholarly journals Multi-scale computational models of the airways to unravel the pathophysiological mechanisms in asthma and chronic obstructive pulmonary disease (AirPROM)

2013 ◽  
Vol 3 (2) ◽  
pp. 20120057 ◽  
Author(s):  
K. S. Burrowes ◽  
J. De Backer ◽  
R. Smallwood ◽  
P. J. Sterk ◽  
I. Gut ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Heart Function ◽  
Scale Model ◽  
Patient Specific ◽  
Chronic Obstructive ◽  
Disease Heterogeneity ◽  
Obstructive Pulmonary Disease ◽  
Pathophysiological Mechanisms ◽  
Multi Scale

The respiratory system comprises several scales of biological complexity: the genes, cells and tissues that work in concert to generate resultant function. Malfunctions of the structure or function of components at any spatial scale can result in diseases, to the detriment of gas exchange, right heart function and patient quality of life. Vast amounts of data emerge from studies across each of the biological scales; however, the question remains: how can we integrate and interpret these data in a meaningful way? Respiratory disease presents a huge health and economic burden, with the diseases asthma and chronic obstructive pulmonary disease (COPD) affecting over 500 million people worldwide. Current therapies are inadequate owing to our incomplete understanding of the disease pathophysiology and our lack of recognition of the enormous disease heterogeneity: we need to characterize this heterogeneity on a patient-specific basis to advance healthcare. In an effort to achieve this goal, the AirPROM consortium ( Air way disease Pr edicting O utcomes through patient-specific computational M odelling) brings together a multi-disciplinary team and a wealth of clinical data. Together we are developing an integrated multi-scale model of the airways in order to unravel the complex pathophysiological mechanisms occurring in the diseases asthma and COPD.

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