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Integration of Clinical Data Collected at Different Times for Virtual Surgery in Single Ventricle Patients: A Case Study

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Abstract

Newborns with single ventricle physiology are usually palliated with a multi-staged procedure. When cardiovascular complications e.g., collateral vessel formation occur during the inter-stage periods, further treatments are required. An 8-month-old patient, who underwent second stage (i.e., bi-directional Glenn, BDG) surgery at 4 months, was diagnosed with a major veno-venous collateral vessel (VVC) which was endovascularly occluded to improve blood oxygen saturations. Few clinical data were collected at 8 months, whereas at 4 months a more detailed data set was available. The aim of this study is threefold: (i) to show how to build a patient-specific model describing the hemodynamics in the presence of VVC, using patient-specific clinical data collected at different times; (ii) to use this model to perform virtual VVC occlusion for quantitative hemodynamics prediction; and (iii) to compare predicted hemodynamics with post-operative measurements. The three-dimensional BDG geometry, resulting from the virtual surgery on the first stage model, was coupled with a lumped parameter model (LPM) of the 8-month patient’s circulation. The latter was developed by scaling the 4-month LPM to account for changes in vascular impedances due to growth and adaptation. After virtual VVC closure, the model confirmed the 2 mmHg BDG pressure increase, as clinically observed, suggesting the importance of modeling vascular adaptation following the BDG procedure.

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Abbreviations

APC:

Aorto-pulmonary collateral vessels

BDG:

Bi-directional Glenn

BSA:

Body surface area

CO :

Cardiac output

CHD:

Congenital heart disease

IVC:

Inferior vena cava

LB:

Lower body

LPM:

Lumped parameter model

MRI:

Magnetic resonance imaging

O2 :

Oxygen

PA:

Pulmonary artery

PVR :

Pulmonary vascular resistance

PVWP:

Pulmonary venous wedge pressure

RPA:

Right pulmonary artery

SVC:

Superior vena cava

SVR LB :

Lower body systemic vascular resistance

SVR UB :

Upper body systemic vascular resistance

3D:

Three-dimensional

UB:

Upper body

VVC:

Veno-venous collateral vessel

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Acknowledgments

This study was supported by Fondation Leducq, Paris, through the Trans-Atlantic Network of Excellence for Cardiovascular Research grant ‘Multi-Scale Modelling of Single Ventricle Hearts for Clinical Decision Support’.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering ‘Giulio Natta’, Politecnico di Milano, Milan, Italy

    Chiara Corsini, Alessia Baretta, Francesco Migliavacca & Giancarlo Pennati

  2. Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, and Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK

    Catriona Baker, Giovanni Biglino & Tain-Yen Hsia

  3. Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA

    Anthony M. Hlavacek

  4. Mechanical Engineering Department, Clemson University, Clemson, SC, USA

    Ethan Kung

  5. Mechanical and Aerospace Engineering Department, University of California San Diego, San Diego, CA, USA

    Ethan Kung & Alison Marsden

  6. INRIA Paris-Rocquencourt, Le Chesnay Cedex, France

    Irene Vignon-Clementel

  7. Laboratoire Jacques-Louis Lions, UPMC Université Paris 6, Paris, France

    Irene Vignon-Clementel

Authors
  1. Chiara Corsini
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  2. Catriona Baker
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  4. Giovanni Biglino
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  6. Tain-Yen Hsia
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  7. Ethan Kung
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  8. Alison Marsden
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  9. Francesco Migliavacca
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  10. Irene Vignon-Clementel
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  11. Giancarlo Pennati
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The Modeling of Congenital Hearts Alliance (MOCHA) Investigators

Corresponding author

Correspondence to Giancarlo Pennati.

Additional information

Associate Editor Umberto Morbiducci oversaw the review of this article.

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Corsini, C., Baker, C., Baretta, A. et al. Integration of Clinical Data Collected at Different Times for Virtual Surgery in Single Ventricle Patients: A Case Study. Ann Biomed Eng 43, 1310–1320 (2015). https://doi.org/10.1007/s10439-014-1113-6

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  • DOI: https://doi.org/10.1007/s10439-014-1113-6

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