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Personalized Perioperative Multi-scale, Multi-physics Heart Simulation of Double Outlet Right Ventricle

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Abstract

For treatment of complex congenital heart disease, computer simulation using a three-dimensional heart model may help to improve outcomes by enabling detailed preoperative evaluations. However, no highly integrated model that accurately reproduces a patient’s pathophysiology, which is required for this simulation has been reported. We modelled a case of complex congenital heart disease, double outlet right ventricle with ventricular septal defect and atrial septal defect. From preoperative computed tomography images, finite element meshes of the heart and torso were created, and cell model of cardiac electrophysiology and sarcomere dynamics was implemented. The parameter values of the heart model were adjusted to reproduce the patient’s electrocardiogram and haemodynamics recorded preoperatively. Two options of in silico surgery were performed using this heart model, and the resulting changes in performance were examined. Preoperative and postoperative simulations showed good agreement with clinical records including haemodynamics and measured oxyhaemoglobin saturations. The use of a detailed sarcomere model also enabled comparison of energetic efficiency between the two surgical options. A novel in silico model of congenital heart disease that integrates molecular models of cardiac function successfully reproduces the observed pathophysiology. The simulation of postoperative state by in silico surgeries can help guide clinical decision-making.

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Acknowledgments

We thank Richard Lipkin, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Conflict of interest

Dr. Okada, Dr. Washio, Dr. Hisada, and Dr. Sugiura have received Grant support from Fujitsu Ltd. The remaining authors have no disclosures.

Funding

This work was supported in part by MEXT as ‘Priority Issue on Post-K-computer’ (Integrated Computational Life Science to Support Personalized and Preventive Medicine, Project ID: hp160209 and hp150260), and by the Japan Society for the Promotion of Science (JSPS) through its ‘Funding Program for World-Leading Innovative R&D on Science and Technology (FIRST Program)’.

Author information

Author notes

  1. Taro Kariya

    Present address: Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA

  2. Shunji Sano

    Present address: Division of Pediatric Cardiothoracic Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA

  3. Ryozo Nagai

    Present address: Jichi Medical University, Tochigi, Japan

  4. Taro Kariya and Takumi Washio contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan

    Taro Kariya & Ryozo Nagai

  2. UT-Heart Inc, The University of Tokyo, Tokyo, Kashiwa-no-ha Campus Station Satellite #304, 178-4-4 Wakashiba, Kashiwa, Chiba, 277-0871, Japan

    Takumi Washio, Jun-ichi Okada, Seiryo Sugiura & Toshiaki Hisada

  3. Next-Generation Healthcare Innovation Center, Fujitsu Ltd., Tokyo, Japan

    Machiko Nakagawa, Masahiro Watanabe & Yoshimasa Kadooka

  4. Department of Cardiac Surgery, Okayama University, Okayama, Japan

    Shunji Sano

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  1. Taro Kariya
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Correspondence to Seiryo Sugiura.

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Associate Editor Aleksander S. Popel oversaw the review of this article.

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Kariya, T., Washio, T., Okada, Ji. et al. Personalized Perioperative Multi-scale, Multi-physics Heart Simulation of Double Outlet Right Ventricle. Ann Biomed Eng 48, 1740–1750 (2020). https://doi.org/10.1007/s10439-020-02488-y

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  • DOI: https://doi.org/10.1007/s10439-020-02488-y

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