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
Identifieur interne : 002063 ( Ncbi/Merge ); précédent : 002062; suivant : 002064Boundary 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
Auteurs : Giancarlo Pennati [Italie] ; Chiara Corsini [Italie] ; Daria Cosentino [Royaume-Uni] ; Tain-Yen Hsia [Royaume-Uni] ; Vincenzo S. Luisi [Italie] ; Gabriele Dubini [Italie] ; Francesco Migliavacca [Italie]Source :
- Interface Focus [ 2042-8898 ] ; 2011.
Abstract
Cavopulmonary connections are surgical procedures used to treat a variety of complex congenital cardiac defects. Virtual pre-operative planning based on
Url:
DOI: 10.1098/rsfs.2010.0021
PubMed: 22670201
PubMed Central: 3262435
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<country xml:lang="fr">Royaume-Uni</country>
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<author><name sortKey="Hsia, Tain Yen" sort="Hsia, Tain Yen" uniqKey="Hsia T" first="Tain-Yen" last="Hsia">Tain-Yen Hsia</name>
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<author><name sortKey="Dubini, Gabriele" sort="Dubini, Gabriele" uniqKey="Dubini G" first="Gabriele" last="Dubini">Gabriele Dubini</name>
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<author><name sortKey="Migliavacca, Francesco" sort="Migliavacca, Francesco" uniqKey="Migliavacca F" first="Francesco" last="Migliavacca">Francesco Migliavacca</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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</title>
<author><name sortKey="Pennati, Giancarlo" sort="Pennati, Giancarlo" uniqKey="Pennati G" first="Giancarlo" last="Pennati">Giancarlo Pennati</name>
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,<country>Italy</country>
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<country xml:lang="fr">Italie</country>
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<author><name sortKey="Corsini, Chiara" sort="Corsini, Chiara" uniqKey="Corsini C" first="Chiara" last="Corsini">Chiara Corsini</name>
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,<institution>Politecnico di Milano</institution>
,<addr-line>Piazza Leonardo da Vinci, 32, 20133 Milan</addr-line>
,<country>Italy</country>
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<country xml:lang="fr">Italie</country>
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<author><name sortKey="Cosentino, Daria" sort="Cosentino, Daria" uniqKey="Cosentino D" first="Daria" last="Cosentino">Daria Cosentino</name>
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,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
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<author><name sortKey="Hsia, Tain Yen" sort="Hsia, Tain Yen" uniqKey="Hsia T" first="Tain-Yen" last="Hsia">Tain-Yen Hsia</name>
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,<country>UK</country>
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<country xml:lang="fr">Royaume-Uni</country>
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<author><name sortKey="Luisi, Vincenzo S" sort="Luisi, Vincenzo S" uniqKey="Luisi V" first="Vincenzo S." last="Luisi">Vincenzo S. Luisi</name>
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,<institution>Fondazione Toscana Gabriele Monasterio—Ospedale del Cuore</institution>
,<addr-line>Via Aurelia Sud, 54100 Massa</addr-line>
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<country xml:lang="fr">Italie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Dubini, Gabriele" sort="Dubini, Gabriele" uniqKey="Dubini G" first="Gabriele" last="Dubini">Gabriele Dubini</name>
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,<country>Italy</country>
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<country xml:lang="fr">Italie</country>
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<author><name sortKey="Migliavacca, Francesco" sort="Migliavacca, Francesco" uniqKey="Migliavacca F" first="Francesco" last="Migliavacca">Francesco Migliavacca</name>
<affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Laboratory of Biological Structure Mechanics, Structural Engineering Department</addr-line>
,<institution>Politecnico di Milano</institution>
,<addr-line>Piazza Leonardo da Vinci, 32, 20133 Milan</addr-line>
,<country>Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<series><title level="j">Interface Focus</title>
<idno type="ISSN">2042-8898</idno>
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<front><div type="abstract" xml:lang="en"><p>Cavopulmonary connections are surgical procedures used to treat a variety of complex congenital cardiac defects. Virtual pre-operative planning based on <italic>in silico</italic>
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.</p>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Interface Focus</journal-id>
<journal-id journal-id-type="publisher-id">RSFS</journal-id>
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<issn pub-type="ppub">2042-8898</issn>
<issn pub-type="epub">2042-8901</issn>
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<title-group><article-title>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</article-title>
<alt-title alt-title-type="short">Virtual surgical planning of TCPC</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Pennati</surname>
<given-names>Giancarlo</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Corsini</surname>
<given-names>Chiara</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cosentino</surname>
<given-names>Daria</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hsia</surname>
<given-names>Tain-Yen</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Luisi</surname>
<given-names>Vincenzo S.</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Dubini</surname>
<given-names>Gabriele</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Migliavacca</surname>
<given-names>Francesco</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
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<aff id="af1"><label>1</label>
<addr-line>Laboratory of Biological Structure Mechanics, Structural Engineering Department</addr-line>
,<institution>Politecnico di Milano</institution>
,<addr-line>Piazza Leonardo da Vinci, 32, 20133 Milan</addr-line>
,<country>Italy</country>
</aff>
<aff id="af2"><label>2</label>
<addr-line>Cardiac Unit</addr-line>
,<institution>Institute of Child Health and Great Ormond Street Hospital for Children</institution>
,<addr-line>Great Ormond Street, London WC1N 3JH</addr-line>
,<country>UK</country>
</aff>
<aff id="af3"><label>3</label>
<addr-line>Paediatric Cardiac Surgery</addr-line>
,<institution>Fondazione Toscana Gabriele Monasterio—Ospedale del Cuore</institution>
,<addr-line>Via Aurelia Sud, 54100 Massa</addr-line>
,<country>Italy</country>
</aff>
<author-notes><corresp id="cor1"><label>*</label>
Author for correspondence (<email>francesco.migliavacca@polimi.it</email>
).</corresp>
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<pub-date pub-type="ppub"><day>6</day>
<month>6</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>9</day>
<month>3</month>
<year>2011</year>
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<volume>1</volume>
<issue>3</issue>
<issue-title>The virtual physiological human Organized by Peter Coveney, Marco Viceconti, Vanessa Dia, Peter Hunter and Peter Kohl</issue-title>
<fpage>297</fpage>
<lpage>307</lpage>
<history><date date-type="received"><day>15</day>
<month>11</month>
<year>2010</year>
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<date date-type="accepted"><day>14</day>
<month>2</month>
<year>2011</year>
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<permissions><copyright-statement>This Journal is © 2011 The Royal Society</copyright-statement>
<copyright-year>2011</copyright-year>
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<abstract><p>Cavopulmonary connections are surgical procedures used to treat a variety of complex congenital cardiac defects. Virtual pre-operative planning based on <italic>in silico</italic>
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.</p>
</abstract>
<kwd-group><kwd>mathematical model</kwd>
<kwd>haemodynamics</kwd>
<kwd>congenital heart diseases</kwd>
<kwd>virtual pre-operative planning</kwd>
<kwd>pulmonary impedances</kwd>
</kwd-group>
</article-meta>
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<affiliations><list><country><li>Italie</li>
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<tree><country name="Italie"><noRegion><name sortKey="Pennati, Giancarlo" sort="Pennati, Giancarlo" uniqKey="Pennati G" first="Giancarlo" last="Pennati">Giancarlo Pennati</name>
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<name sortKey="Corsini, Chiara" sort="Corsini, Chiara" uniqKey="Corsini C" first="Chiara" last="Corsini">Chiara Corsini</name>
<name sortKey="Dubini, Gabriele" sort="Dubini, Gabriele" uniqKey="Dubini G" first="Gabriele" last="Dubini">Gabriele Dubini</name>
<name sortKey="Luisi, Vincenzo S" sort="Luisi, Vincenzo S" uniqKey="Luisi V" first="Vincenzo S." last="Luisi">Vincenzo S. Luisi</name>
<name sortKey="Migliavacca, Francesco" sort="Migliavacca, Francesco" uniqKey="Migliavacca F" first="Francesco" last="Migliavacca">Francesco Migliavacca</name>
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<country name="Royaume-Uni"><noRegion><name sortKey="Cosentino, Daria" sort="Cosentino, Daria" uniqKey="Cosentino D" first="Daria" last="Cosentino">Daria Cosentino</name>
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<name sortKey="Hsia, Tain Yen" sort="Hsia, Tain Yen" uniqKey="Hsia T" first="Tain-Yen" last="Hsia">Tain-Yen Hsia</name>
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