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Patient-specific finite element modeling of the Cardiokinetix Parachute® device: effects on left ventricular wall stress and function

  • Lik Chuan Lee
  • Liang Ge
  • Zhihong Zhang
  • Matthew Pease
  • Serjan D. Nikolic
  • Rakesh Mishra
  • Mark B. RatcliffeEmail author
  • Julius M. Guccione
Original Article

Abstract

The Parachute® (Cardiokinetix, Inc., Menlo Park, California) is a catheter-based device intended to reverse left ventricular (LV) remodeling after antero-apical myocardial infarction. When deployed, the device partitions the LV into upper and lower chambers. To simulate its mechanical effects, we created a finite element LV model based on computed tomography (CT) images from a patient before and 6 months after Parachute® implantation. Acute mechanical effects were determined by in silico device implantation (VIRTUAL-Parachute). Chronic effects of the device were determined by adjusting the diastolic and systolic material parameters to better match the 6-month post-implantation CT data and LV pressure data at end-diastole (ED) (POST-OP). Regional myofiber stress and pump function were calculated in each case. The principal finding is that VIRTUAL-Parachute was associated with a 61.2 % reduction in the lower chamber myofiber stress at ED. The POST-OP model was associated with a decrease in LV diastolic stiffness and a larger reduction in myofiber stress at the upper (27.1 %) and lower chamber (78.4 %) at ED. Myofiber stress at end-systole and stroke volume was little changed in the POST-OP case. These results suggest that the primary mechanism of Parachute® is a reduction in ED myofiber stress, which may reverse eccentric post-infarct LV hypertrophy.

Keywords

Myocardial infarction Remodeling Finite element method Surgical ventricular restoration 

Notes

Acknowledgments

This study was supported by an unrestricted gift from Cardiokinetix and NIH grants R01-HL-084431 (Dr. Ratcliffe), R01-HL-077921 and R01-HL-118627 (Dr. Guccione).

Supplementary material

Supplementary material 1 (MPG 1003 kb)

Supplementary material 2 (AVI 9043 kb)

11517_2014_1159_MOESM3_ESM.docx (435 kb)
Supplementary material 3 (DOCX 435 kb)

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Copyright information

© International Federation for Medical and Biological Engineering (outside the USA) 2014

Authors and Affiliations

  • Lik Chuan Lee
    • 1
    • 2
    • 4
  • Liang Ge
    • 1
    • 2
    • 4
  • Zhihong Zhang
    • 4
  • Matthew Pease
    • 5
  • Serjan D. Nikolic
    • 5
  • Rakesh Mishra
    • 3
    • 4
  • Mark B. Ratcliffe
    • 1
    • 2
    • 4
    Email author
  • Julius M. Guccione
    • 1
    • 2
    • 4
  1. 1.Departments of SurgeryUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of BioengineeringUniversity of CaliforniaSan FranciscoUSA
  3. 3.Department of MedicineUniversity of CaliforniaSan FranciscoUSA
  4. 4.Division of Surgical Services (112)San Francisco Veterans Affairs Medical CenterSan FranciscoUSA
  5. 5.Cardiokinetix, Inc.Menlo ParkUSA

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