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Patient specific fluid–structure ventricular modelling for integrated cardiac care

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Abstract

Cardiac diseases represent one of the primary causes of mortality and result in a substantial decrease in quality of life. Optimal surgical planning and long-term treatment are crucial for a successful and cost-effective patient care. Recently developed state-of-the-art imaging techniques supply a wealth of detailed data to support diagnosis. This provides the foundations for a novel approach to clinical planning based on personalisation, which can lead to more tailored treatment plans when compared to strategies based on standard population metrics. The goal of this study is to develop and apply a methodology for creating personalised ventricular models of blood and tissue mechanics to assess patient-specific metrics. Fluid–structure interaction simulations are performed to analyse the diastolic function in hypoplastic left heart patients, who underwent the first stage of a three-step surgical palliation and whose condition must be accurately evaluated to plan further intervention. The kinetic energy changes generated by the blood propagation in early diastole are found to reflect the intraventricular pressure gradient, giving indications on the filling efficiency. This suggests good agreement between the 3D model and the Euler equation, which provides a simplified relationship between pressure and kinetic energy and could, therefore, be applied in the clinical context.

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Abbreviations

HLHS:

Hypoplastic left heart syndrome

LV, RV:

Left ventricle/right ventricle

TDI:

Tissue Doppler imaging

MRI:

Magnetic resonance imaging

Ωf,s :

Fluid and solid domain

Λf,s :

Fluid and solid reference domain

Γ Df.s :

Fluid and solid Dirichlet boundary

Γ Nf.s :

Fluid and solid Neumann boundary

ρ f,s :

Fluid and solid density

J f,s :

Fluid and solid Jacobian

σ f,s :

Fluid and solid stress tensor

t f,s :

Fluid and solid traction

σ iso :

Isotropic stress tensor

p f,s :

Fluid and solid pressure

v :

Fluid velocity

w :

Domain velocity

u :

Solid displacement

x :

Physical coordinate system

η :

Reference coordinate system

F :

Deformation gradient tensor

T :

Second Poila–Kirchhoff tensor

Q :

Orthonormal rotation tensor

E F :

Green strain tensor

α ij :

Costa Law coefficients

W:

Strain energy function

Ψ:

Density function

r(s):

Trajectory along streamline s

p base v base :

Fluid velocity/pressure in the base region

p apex v apex :

Fluid velocity/pressure in the apical region

M :

Momentum change along a streamline

E k :

Kinetic energy

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Authors and Affiliations

  1. Imaging Science and Biomedical Engineering Division, St Thomas’ Hospital, King’s College London, London, UK

    A. de Vecchi, D. A. Nordsletten, R. Razavi, G. Greil & N. P. Smith

  2. Evelina Children’s Hospital, St Thomas’ Hospital, London, SE1 7EH, UK

    G. Greil

  3. Computing Laboratory, University of Oxford, Oxford, UK

    N. P. Smith

Authors
  1. A. de Vecchi
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  2. D. A. Nordsletten
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  3. R. Razavi
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  4. G. Greil
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  5. N. P. Smith
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Correspondence to N. P. Smith.

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de Vecchi, A., Nordsletten, D.A., Razavi, R. et al. Patient specific fluid–structure ventricular modelling for integrated cardiac care. Med Biol Eng Comput 51, 1261–1270 (2013). https://doi.org/10.1007/s11517-012-1030-5

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  • DOI: https://doi.org/10.1007/s11517-012-1030-5

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