Biomechanical Modeling to Inform Pulmonary Valve Replacement in Tetralogy of Fallot Patients after Complete Repair

Autor: Gerald F. Greil, Radomir Chabiniok, Keren Hasbani, Dominique Chapelle, Camille L. Hancock Friesen, Maria Gusseva, Animesh Tandon, Cécile Patte, Philippe Moireau, Tarique Hussain, Martin Genet
Přispěvatelé: Mathematical and Mechanical Modeling with Data Interaction in Simulations for Medicine (M3DISIM), Laboratoire de mécanique des solides (LMS), École polytechnique (X)-Mines Paris - PSL (École nationale supérieure des mines de Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Mines Paris - PSL (École nationale supérieure des mines de Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), University of Texas Southwestern Medical Center [Dallas], University of Texas at Austin [Austin], Czech Technical University in Prague (CTU), King‘s College London, Guy's and St Thomas' Hospital [London], École polytechnique (X)-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-MINES ParisTech - École nationale supérieure des mines de Paris
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
Reoperation
medicine.medical_specialty
Percutaneous
Heart Ventricles
0206 medical engineering
Magnetic Resonance Imaging
Cine
02 engineering and technology
030204 cardiovascular system & hematology
Models
Biological
Article
Contractility
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Cardiovascular modeling
Pulmonary Valve Replacement
Internal medicine
medicine.artery
Humans
Medicine
Abnormalities
Multiple
Cardiac Surgical Procedures
Retrospective Studies
Tetralogy of Fallot
Heart Valve Prosthesis Implantation
Cardiovascular magnetic resonance imaging
Pulmonary Valve
medicine.diagnostic_test
business.industry
Hemodynamics
Magnetic resonance imaging
Retrospective cohort study
Translational research
medicine.disease
020601 biomedical engineering
Personalized medicine
Pulmonary Valve Insufficiency
Pulmonary artery
Cardiology
Female
Biomechanical model
[SDV.IB]Life Sciences [q-bio]/Bioengineering
Myocardial contractility
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Canadian Journal of Cardiology
Canadian Journal of Cardiology, 2021, 37, pp.1798-1807. ⟨10.1016/j.cjca.2021.06.018⟩
Canadian Journal of Cardiology, Elsevier, 2021, 37, pp.1798-1807. ⟨10.1016/j.cjca.2021.06.018⟩
Can J Cardiol
ISSN: 0828-282X
1916-7075
DOI: 10.1016/j.cjca.2021.06.018⟩
Popis: BACKGROUND: A biomechanical model of the heart can be used to incorporate multiple data sources (electrocardiography, imaging, invasive hemodynamics). The purpose of this study was to use this approach in a cohort of patients with tetralogy of Fallot after complete repair (rTOF) to assess comparative influences of residual right ventricular outflow tract obstruction (RVOTO) and pulmonary regurgitation on ventricular health. METHODS: Twenty patients with rTOF who underwent percutaneous pulmonary valve replacement (PVR) and cardiovascular magnetic resonance imaging were included in this retrospective study. RESULTS: RV contractility before PVR (mean 66 ± kPa, mean ± standard deviation) was increased in patients with rTOF compared with normal RV (38–48 kPa) (P < 0.05). The contractility decreased significantly in all patients after PVR (P < 0.05). Patients with predominantly RVOTO demonstrated greater reduction in contractility (median decrease 35%) after PVR than those with predominant pulmonary regurgitation (median decrease 11%). The model simulated post-PVR decreased EDV for the majority and suggested an increase of Q(eff)—both in line with published data. CONCLUSIONS: This study used a biomechanical model to synthesize multiple clinical inputs and give an insight into RV health. Individualized modeling allows us to predict the RV response to PVR. Initial data suggest that residual RVOTO imposes greater ventricular work than isolated pulmonary regurgitation. Biomechanical models specific to individual patient and physiology (before and after PVR) were created and used to estimate the RV myocardial contractility. The ability of models to capture post-PVR changes of right ventricular (RV) end-diastolic volume (EDV) and effective flow in the pulmonary artery (Qeff) was also compared with expected values.
Databáze: OpenAIRE
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