Calibration of an Electrical Analog Model of Liver Hemodynamics in Fontan Patients
| Autor: | Elyar Abbasi Bavil, Luc Mertens, Thomas L. Forbes, Rachel M. Wald, Cristina H. Amon, Matthew G. Doyle, Charlotte Debbaut |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
congenital hereditary and neonatal diseases and abnormalities Technology and Engineering medicine.medical_treatment Portal venous pressure Biomedical Engineering Hemodynamics fluid dynamics 030204 cardiovascular system & hematology Fontan procedure 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine Physiology (medical) medicine electrical analog model liver hemodynamics In vivo measurements Pressure gradient business.industry Electrical analog biological system modeling medicine.disease Portal Pressure medicine.anatomical_structure Ventricle Cardiology 030211 gastroenterology & hepatology business |
| Zdroj: | JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME |
| ISSN: | 1528-8951 0148-0731 |
| Popis: | Fontan associated liver disease is a common complication in patients with Fontan circulation, who were born with a single functioning heart ventricle. The hepatic venous pressure gradient (HVPG) is used to assess liver health and is a surrogate measure of the pressure gradient across the entire liver (portal pressure gradient (PPG)). However, it is thought to be inaccurate in Fontan patients. The main objectives of this study were (1) to apply an existing detailed lumped parameter model (LPM) of the liver to Fontan patients using patient-specific clinical data and (2) to determine whether HVPG is a suitable measurement of PPGs in these patients. An existing LPM of the liver blood circulation was applied and tuned to simulate patient-specific liver hemodynamics. Geometries were collected from seven adult Fontan patients and used to evaluate model parameters. The model was solved and tuned using waveform measurements of flows, inlet and outlet pressures. The predicted ratio of portal to hepatic venous pressures is comparable to in vivo measurements. The results confirmed that HVPG is not suitable for Fontan patients, as it would underestimate the portal pressures gradient by a factor of 3 to 4. Our patient-specific liver model provides an estimate of the pressure drop across the liver, which differs from the clinically used metric HVPG. This work represents a first step toward models suitable to assess liver health in Fontan patients and improve its long-term management. |
| Databáze: | OpenAIRE |
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