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Yang W, Conover TA, Figliola RS, Giridharan GA, Marsden AL, Rodefeld MD. Passive performance evaluation and validation of a viscous impeller pump for subpulmonary fontan circulatory support. Sci Rep 2023; 13:12668. [PMID: 37542111 PMCID: PMC10403595 DOI: 10.1038/s41598-023-38559-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/11/2023] [Indexed: 08/06/2023] Open
Abstract
Patients with single ventricle defects undergoing the Fontan procedure eventually face Fontan failure. Long-term cavopulmonary assist devices using rotary pump technologies are currently being developed as a subpulmonary power source to prevent and treat Fontan failure. Low hydraulic resistance is a critical safety requirement in the event of pump failure (0 RPM) as a modest 2 mmHg cavopulmonary pressure drop can compromise patient hemodynamics. The goal of this study is therefore to assess the passive performance of a viscous impeller pump (VIP) we are developing for Fontan patients, and validate flow simulations against in-vitro data. Two different blade heights (1.09 mm vs 1.62 mm) and a blank housing model were tested using a mock circulatory loop (MCL) with cardiac output ranging from 3 to 11 L/min. Three-dimensional flow simulations were performed and compared against MCL data. In-silico and MCL results demonstrated a pressure drop of < 2 mmHg at a cardiac output of 7 L/min for both blade heights. There was good agreement between simulation and MCL results for pressure loss (mean difference - 0.23 mmHg 95% CI [0.24-0.71]). Compared to the blank housing model, low wall shear stress area and oscillatory shear index on the pump surface were low, and mean washout times were within 2 s. This study demonstrated the low resistance characteristic of current VIP designs in the failed condition that results in clinically acceptable minimal pressure loss without increased washout time as compared to a blank housing model under normal cardiac output in Fontan patients.
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Affiliation(s)
- Weiguang Yang
- Department of Pediatrics (Cardiology), Stanford University, Stanford, CA, USA.
| | - Timothy A Conover
- Departments of Mechanical Engineering, Clemson University, Clemson, SC, USA
| | - Richard S Figliola
- Departments of Mechanical Engineering, Clemson University, Clemson, SC, USA
| | | | - Alison L Marsden
- Department of Pediatrics (Cardiology), Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Mark D Rodefeld
- Section of Cardiothoracic Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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Schwarz EL, Pegolotti L, Pfaller MR, Marsden AL. Beyond CFD: Emerging methodologies for predictive simulation in cardiovascular health and disease. BIOPHYSICS REVIEWS 2023; 4:011301. [PMID: 36686891 PMCID: PMC9846834 DOI: 10.1063/5.0109400] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/12/2022] [Indexed: 01/15/2023]
Abstract
Physics-based computational models of the cardiovascular system are increasingly used to simulate hemodynamics, tissue mechanics, and physiology in evolving healthy and diseased states. While predictive models using computational fluid dynamics (CFD) originated primarily for use in surgical planning, their application now extends well beyond this purpose. In this review, we describe an increasingly wide range of modeling applications aimed at uncovering fundamental mechanisms of disease progression and development, performing model-guided design, and generating testable hypotheses to drive targeted experiments. Increasingly, models are incorporating multiple physical processes spanning a wide range of time and length scales in the heart and vasculature. With these expanded capabilities, clinical adoption of patient-specific modeling in congenital and acquired cardiovascular disease is also increasing, impacting clinical care and treatment decisions in complex congenital heart disease, coronary artery disease, vascular surgery, pulmonary artery disease, and medical device design. In support of these efforts, we discuss recent advances in modeling methodology, which are most impactful when driven by clinical needs. We describe pivotal recent developments in image processing, fluid-structure interaction, modeling under uncertainty, and reduced order modeling to enable simulations in clinically relevant timeframes. In all these areas, we argue that traditional CFD alone is insufficient to tackle increasingly complex clinical and biological problems across scales and systems. Rather, CFD should be coupled with appropriate multiscale biological, physical, and physiological models needed to produce comprehensive, impactful models of mechanobiological systems and complex clinical scenarios. With this perspective, we finally outline open problems and future challenges in the field.
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Affiliation(s)
- Erica L. Schwarz
- Departments of Pediatrics and Bioengineering, Stanford University, Stanford, California 94305, USA
| | - Luca Pegolotti
- Departments of Pediatrics and Bioengineering, Stanford University, Stanford, California 94305, USA
| | - Martin R. Pfaller
- Departments of Pediatrics and Bioengineering, Stanford University, Stanford, California 94305, USA
| | - Alison L. Marsden
- Departments of Pediatrics and Bioengineering, Stanford University, Stanford, California 94305, USA
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Lan IS, Liu J, Yang W, Zimmermann J, Ennis DB, Marsden AL. Validation of the Reduced Unified Continuum Formulation Against In Vitro 4D-Flow MRI. Ann Biomed Eng 2023; 51:377-393. [PMID: 35963921 PMCID: PMC11402517 DOI: 10.1007/s10439-022-03038-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023]
Abstract
We previously introduced and verified the reduced unified continuum formulation for vascular fluid-structure interaction (FSI) against Womersley's deformable wall theory. Our present work seeks to investigate its performance in a patient-specific aortic setting in which assumptions of idealized geometries and velocity profiles are invalid. Specifically, we leveraged 2D magnetic resonance imaging (MRI) and 4D-flow MRI to extract high-resolution anatomical and hemodynamic information from an in vitro flow circuit embedding a compliant 3D-printed aortic phantom. To accurately reflect experimental conditions, we numerically implemented viscoelastic external tissue support, vascular tissue prestressing, and skew boundary conditions enabling in-plane vascular motion at each inlet and outlet. Validation of our formulation is achieved through close quantitative agreement in pressures, lumen area changes, pulse wave velocity, and early systolic velocities, as well as qualitative agreement in late systolic flow structures. Our validated suite of FSI techniques offers a computationally efficient approach for numerical simulation of vascular hemodynamics. This study is among the first to validate a cardiovascular FSI formulation against an in vitro flow circuit involving a compliant vascular phantom of complex patient-specific anatomy.
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Affiliation(s)
- Ingrid S Lan
- Department of Bioengineering, Stanford University, Clark Center E1.3 318 Campus Drive, Stanford, CA, 94305-5428, USA
| | - Ju Liu
- Department of Mechanics and Aerospace Engineering, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, People's Republic of China
- Guangdong-Hong Kong-Macao Joint Laboratory for Data-Driven Fluid Mechanics and Engineering Applications, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, People's Republic of China
| | - Weiguang Yang
- Department of Pediatrics (Cardiology), Stanford University, Stanford, CA, 94305, USA
| | - Judith Zimmermann
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
- Department of Informatics, Technical University of Munich, 85748, Garching, Germany
| | - Daniel B Ennis
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
- Division of Radiology, Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA
| | - Alison L Marsden
- Department of Bioengineering, Stanford University, Clark Center E1.3 318 Campus Drive, Stanford, CA, 94305-5428, USA.
- Department of Pediatrics (Cardiology), Stanford University, Stanford, CA, 94305, USA.
- Institute for Computational and Mathematical Engineering, Stanford University, Stanford, CA, 94305, USA.
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Xu KW, Gao Q, Wan M, Zhang K. Mock circulatory loop applications for testing cardiovascular assist devices and in vitro studies. Front Physiol 2023; 14:1175919. [PMID: 37123281 PMCID: PMC10133581 DOI: 10.3389/fphys.2023.1175919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/03/2023] [Indexed: 05/02/2023] Open
Abstract
The mock circulatory loop (MCL) is an in vitro experimental system that can provide continuous pulsatile flows and simulate different physiological or pathological parameters of the human circulation system. It is of great significance for testing cardiovascular assist device (CAD), which is a type of clinical instrument used to treat cardiovascular disease and alleviate the dilemma of insufficient donor hearts. The MCL installed with different types of CADs can simulate specific conditions of clinical surgery for evaluating the effectiveness and reliability of those CADs under the repeated performance tests and reliability tests. Also, patient-specific cardiovascular models can be employed in the circulation of MCL for targeted pathological study associated with hemodynamics. Therefore, The MCL system has various combinations of different functional units according to its richful applications, which are comprehensively reviewed in the current work. Four types of CADs including prosthetic heart valve (PHV), ventricular assist device (VAD), total artificial heart (TAH) and intra-aortic balloon pump (IABP) applied in MCL experiments are documented and compared in detail. Moreover, MCLs with more complicated structures for achieving advanced functions are further introduced, such as MCL for the pediatric application, MCL with anatomical phantoms and MCL synchronizing multiple circulation systems. By reviewing the constructions and functions of available MCLs, the features of MCLs for different applications are summarized, and directions of developing the MCLs are suggested.
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Affiliation(s)
- Ke-Wei Xu
- Department of Engineering Mechanics, School of Aeronautics and Astronautics, Zhejiang University, Hangzhou, China
| | - Qi Gao
- Department of Engineering Mechanics, School of Aeronautics and Astronautics, Zhejiang University, Hangzhou, China
- *Correspondence: Qi Gao,
| | - Min Wan
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, China
| | - Ke Zhang
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, Jinan, China
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Characterization of the Ejector Pump Performance for the Assisted Bidirectional Glenn Procedure. FLUIDS 2022. [DOI: 10.3390/fluids7010031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study introduces an algebraic model informed by computational fluid dynamics (CFD) simulations to investigate the performance of the assisted bidirectional Glenn (ABG) operation on a broad range of conditions. The performance of this operation, as measured by the superior vena cava (SVC) pressure, depends on the nozzle area in its ejector pump and the patient’s pulmonary vascular resistance (PVR). Using the developed algebraic model to explore this two-dimensional parameter space shows that the ejector pump can create a pressure difference between the pulmonary artery and the SVC as high as 5 mmHg. The lowest SVC pressure is produced at a nozzle area that decreases linearly with the PVR such that, at PVR =4.2 (Wood units-m2), there is no added benefit in utilizing the ejector pump effect (optimal nozzle area is zero, corresponding to the bidirectional Glenn circulation). At PVR =2 (Wood units-m2), the SVC pressure can be lowered to less than 4 mmHg by using an optimal nozzle area of ≈2.5 mm2. Regardless of the PVR, adding a 2 mm2 nozzle to the baseline bidirectional Glenn boosts the oxygen saturation and delivery by at least 15%. The SVC pressure for that 2 mm2 nozzle remains below 14 mmHg for all PVRs less than 7 Wood units-m2. The mechanical efficiency of the optimal designs consistently remains below 30%, indicating the potential for improvement in the future. A good agreement is observed between the algebraic model and high-fidelity CFD simulations.
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Jia D, Peroni M, Khalapyan T, Esmaily M. An Efficient Assisted Bidirectional Glenn Design With Lowered Superior Vena Cava Pressure for Stage-One Single Ventricle Patients. J Biomech Eng 2021; 143:071008. [PMID: 33590839 DOI: 10.1115/1.4050170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Indexed: 11/08/2022]
Abstract
Recently, the assisted bidirectional Glenn (ABG) procedure has been proposed as an alternative to the modified Blalock-Taussig shunt (mBTS) operation for neonates with single-ventricle physiology. Despite success in reducing heart workload and maintaining sufficient pulmonary flow, the ABG also raised the superior vena cava (SVC) pressure to a level that may not be tolerated by infants. To lower the SVC pressure, we propose a modified version of the ABG (mABG), in which a shunt with a slit-shaped nozzle exit is inserted at the junction of the right and left brachiocephalic veins. The proposed operation is compared against the ABG, the mBTS, and the bidirectional Glenn (BDG) operations using closed-loop multiscale simulations. Both normal (2.3 Wood units-m2) and high (7 Wood units-m2) pulmonary vascular resistance (PVR) values are simulated. The mABG provides the highest oxygen saturation, oxygen delivery, and pulmonary flow rate in comparison to the BDG and the ABG. At normal PVR, the SVC pressure is significantly reduced below that of the ABG and the BDG (mABG: 4; ABG: 8; BDG: 6; mBTS: 3 mmHg). However, the SVC pressure remains high at high PVR (mABG: 15; ABG: 16; BDG: 12; mBTS: 3 mmHg), motivating an optimization study to improve the ABG hemodynamics efficiency for a broader range of conditions in the future. Overall, the mABG preserves all advantages of the original ABG procedure while reducing the SVC pressure at normal PVR.
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Affiliation(s)
- Dongjie Jia
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14850
| | - Matthew Peroni
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14850
| | | | - Mahdi Esmaily
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY 14850
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McHugo VS, Nolke L, Delassus P, MaCarthy E, McMahon CJ, Morris L. The impact of compliance on Stage 2 uni-ventricular heart circulation: An experimental assessment of the Bidirectional Glenn. Med Eng Phys 2020; 84:184-192. [PMID: 32977917 DOI: 10.1016/j.medengphy.2020.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 03/11/2020] [Accepted: 07/13/2020] [Indexed: 11/30/2022]
Abstract
The Bidirectional Glenn (BDG) or cavopulmonary connection is typically undertaken to volume unload the single ventricle in an effort to preserve ventricular and atrioventricular valve function. The geometry of this surgical palliation has been shown to influence the fluid energy loss as well as the distribution of flow that enters through the superior vena cava. In-vitro and in-silico studies to date have been performed on rigid wall models, while this investigation looks at the impact of flexible thin walled models versus rigid walls. Rigid and compliant models of two patient-specific Glenn geometries were fabricated and tested under various flow conditions, within a biosimulator capable of replicating patient specific flow conditions. It was found that the compliant models exhibit greater levels of energy loss compared to the rigid models. Along with these findings greater levels of turbulence was found in both compliant models compared to their rigid counterparts under ultrasound examinations. This shows that vessel compliance has a significant impact on the hemodynamics within hypoplastic left heart syndrome.
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Affiliation(s)
- V S McHugo
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland.
| | - L Nolke
- Department of Pediatric Cardiology Our Lady's Children's Hospital Crumlin, Dublin, Ireland; University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - P Delassus
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland
| | - E MaCarthy
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland
| | - C J McMahon
- Department of Pediatric Cardiology Our Lady's Children's Hospital Crumlin, Dublin, Ireland; University College Dublin School of Medicine, Belfield, Dublin, Ireland.
| | - L Morris
- Department of Mechanical and Industrial Engineering (GMIT), Galway Medical Technology Centre, Ireland.
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Shang JK, Esmaily M, Verma A, Reinhartz O, Figliola RS, Hsia TY, Feinstein JA, Marsden AL. Patient-Specific Multiscale Modeling of the Assisted Bidirectional Glenn. Ann Thorac Surg 2018; 107:1232-1239. [PMID: 30471273 DOI: 10.1016/j.athoracsur.2018.10.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND First-stage palliation of neonates with single-ventricle physiology is associated with poor outcomes and challenging clinical management. Prior computational modeling and in vitro experiments introduced the assisted bidirectional Glenn (ABG), which increased pulmonary flow and oxygenation over the bidirectional Glenn (BDG) and the systemic-to-pulmonary shunt in idealized models. In this study, we demonstrate that the ABG achieves similar performance in patient-specific models and assess the influence of varying shunt geometry. METHODS In a small cohort of single-ventricle prestage 2 patients, we constructed three-dimensional in silico models and tuned lumped parameter networks to match clinical measurements. Each model was modified to produce virtual BDG and ABG surgeries. We simulated the hemodynamics of the stage 1 procedure, BDG, and ABG by using multiscale computational modeling, coupling a finite-element flow solver to the lumped parameter network. Two levels of pulmonary vascular resistances (PVRs) were investigated: baseline (low) PVR of the patients and doubled (high) PVR. The shunt nozzle diameter, anastomosis location, and shape were also manipulated. RESULTS The ABG increased the pulmonary flow rate and pressure by 15% to 20%, which was accompanied by a rise in superior vena caval pressure (2 to 3 mm Hg) at both PVR values. Pulmonary flow rate and superior vena caval pressures were most sensitive to the shunt nozzle diameter. CONCLUSIONS Patient-specific ABG performance was similar to prior idealized simulations and experiments, with good performance at lower PVR values in the range of measured clinical data. Larger shunt outlet diameters and lower PVR led to improved ABG performance.
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Affiliation(s)
- Jessica K Shang
- Department of Mechanical Engineering, University of Rochester, Rochester, New York.
| | - Mahdi Esmaily
- Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Aekaansh Verma
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Olaf Reinhartz
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Richard S Figliola
- Department of Mechanical Engineering, Clemson University, Clemson, South Carolina
| | - Tian-Yen Hsia
- Pediatric Cardiac Surgery, Yale New Haven Children's Hospital, New Haven, Connecticut
| | - Jeffrey A Feinstein
- Department of Pediatrics, Stanford University School of Medicine, Lucile Salter Packard Children's Hospital, Palo Alto, California; Department of Bioengineering, Stanford University, Stanford, California
| | - Alison L Marsden
- Department of Pediatrics, Bioengineering and ICME, Stanford University, Stanford, California
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Verma A, Esmaily M, Shang J, Figliola R, Feinstein JA, Hsia TY, Marsden AL. Optimization of the Assisted Bidirectional Glenn Procedure for First Stage Single Ventricle Repair. World J Pediatr Congenit Heart Surg 2018; 9:157-170. [PMID: 29544408 PMCID: PMC6668725 DOI: 10.1177/2150135117745026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND First-stage single-ventricle palliation is challenging to manage, and significant interstage morbidity and mortality remain. Prior computational and in vitro studies of the assisted bidirectional Glenn (ABG), a novel first-stage procedure that has shown potential for early conversion to a more stable augmented Glenn physiology, demonstrated increased pulmonary flow and oxygen delivery while decreasing cardiac work, as compared to conventional stage-1 alternatives. This study aims to identify optimal shunt designs for the ABG to improve pulmonary flow while maintaining or decreasing superior vena caval (SVC) pressure. METHODS A representative three-dimensional model of a neonatal bidirectional Glenn (BDG) was created, with a shunt connecting the innominate artery to the SVC. The shunt design was studied as a six-parameter constrained shape optimization problem. We simulated hemodynamics for each candidate designs using a multiscale finite element flow solver and compared performance against designs with taper-less shunts, the standalone BDG, and a simplified control volume model. Three values of pulmonary vascular resistance (PVR) of 2.3, 4.3, and 7.1 WUm2 were studied. RESULTS Increases in pulmonary flow were generally accompanied by increases in SVC pressure, except at low PVR (2.3 WUm2), where the optimal shunt geometry achieved a 13% increase in pulmonary flow without incurring any increase in SVC pressure. Shunt outlet area was the most influential design parameter, while others had minimal effect. CONCLUSION Assisted bidirectional Glenn performance is sensitive to PVR and shunt outlet diameter. An increase in pulmonary flow without a corresponding increase in SVC pressure is possible only when PVR is low.
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Affiliation(s)
- Aekaansh Verma
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Mahdi Esmaily
- Center for Turbulence Research, Stanford University, Stanford, CA, USA
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, USA
| | - Jessica Shang
- Department of Mechanical Engineering, University of Rochester, Rochester, NY, USA
| | - Richard Figliola
- Department of Mechanical Engineering, Clemson University, Clemson, SC, USA
| | - Jeffrey A. Feinstein
- Department of Pediatrics, Stanford University School of Medicine, Lucile Salter Packard Children’s Hospital, Palo Alto, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Tain-Yen Hsia
- Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS-Trust, London, UK
| | - Alison L. Marsden
- Department of Pediatrics, Stanford University School of Medicine, Lucile Salter Packard Children’s Hospital, Palo Alto, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
- Institute for Computational and Mathematical Engineering, Stanford University, CA, USA
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Conover T, Hlavacek AM, Migliavacca F, Kung E, Dorfman A, Figliola RS, Hsia TY, Taylor A, Khambadkone S, Schievano S, de Leval M, Hsia TY, Bove E, Dorfman A, Baker GH, Hlavacek A, Migliavacca F, Pennati G, Dubini G, Marsden A, Vignon-Clementel I, Figliola R, McGregor J. An interactive simulation tool for patient-specific clinical decision support in single-ventricle physiology. J Thorac Cardiovasc Surg 2018; 155:712-721. [DOI: 10.1016/j.jtcvs.2017.09.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 08/20/2017] [Accepted: 09/10/2017] [Indexed: 10/18/2022]
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Vedula V, Lee J, Xu H, Kuo CCJ, Hsiai TK, Marsden AL. A method to quantify mechanobiologic forces during zebrafish cardiac development using 4-D light sheet imaging and computational modeling. PLoS Comput Biol 2017; 13:e1005828. [PMID: 29084212 PMCID: PMC5679653 DOI: 10.1371/journal.pcbi.1005828] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 11/09/2017] [Accepted: 10/15/2017] [Indexed: 01/09/2023] Open
Abstract
Blood flow and mechanical forces in the ventricle are implicated in cardiac development and trabeculation. However, the mechanisms of mechanotransduction remain elusive. This is due in part to the challenges associated with accurately quantifying mechanical forces in the developing heart. We present a novel computational framework to simulate cardiac hemodynamics in developing zebrafish embryos by coupling 4-D light sheet imaging with a stabilized finite element flow solver, and extract time-dependent mechanical stimuli data. We employ deformable image registration methods to segment the motion of the ventricle from high resolution 4-D light sheet image data. This results in a robust and efficient workflow, as segmentation need only be performed at one cardiac phase, while wall position in the other cardiac phases is found by image registration. Ventricular hemodynamics are then quantified by numerically solving the Navier-Stokes equations in the moving wall domain with our validated flow solver. We demonstrate the applicability of the workflow in wild type zebrafish and three treated fish types that disrupt trabeculation: (a) chemical treatment using AG1478, an ErbB2 signaling inhibitor that inhibits proliferation and differentiation of cardiac trabeculation; (b) injection of gata1a morpholino oligomer (gata1aMO) suppressing hematopoiesis and resulting in attenuated trabeculation; (c) weak-atriumm58 mutant (wea) with inhibited atrial contraction leading to a highly undeveloped ventricle and poor cardiac function. Our simulations reveal elevated wall shear stress (WSS) in wild type and AG1478 compared to gata1aMO and wea. High oscillatory shear index (OSI) in the grooves between trabeculae, compared to lower values on the ridges, in the wild type suggest oscillatory forces as a possible regulatory mechanism of cardiac trabeculation development. The framework has broad applicability for future cardiac developmental studies focused on quantitatively investigating the role of hemodynamic forces and mechanotransduction during morphogenesis.
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Affiliation(s)
- Vijay Vedula
- Department of Pediatrics (Cardiology), Stanford University, Stanford, California, United States of America
| | - Juhyun Lee
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Hao Xu
- Department of Electrical Engineering, University of Southern California, Los Angeles, California, United States of America
| | - C.-C. Jay Kuo
- Department of Electrical Engineering, University of Southern California, Los Angeles, California, United States of America
| | - Tzung K. Hsiai
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, United States of America
- Department of Medicine, Division of Cardiology, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Alison L. Marsden
- Department of Pediatrics (Cardiology), Stanford University, Stanford, California, United States of America
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
- Institute for Computational and Mathematical Engineering (ICME), Stanford University, Stanford, California, United States of America
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Hsia TY, Figliola R. Multiscale modelling of single-ventricle hearts for clinical decision support: a Leducq Transatlantic Network of Excellence. Eur J Cardiothorac Surg 2015; 49:365-8. [PMID: 26489838 DOI: 10.1093/ejcts/ezv368] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tain-Yen Hsia
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Richard Figliola
- Department of Mechanical and Bioengineering, Clemson University, Clemson, NC, USA
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Abstract
PURPOSE OF REVIEW Recent methodological advances in computational simulations are enabling increasingly realistic simulations of hemodynamics and physiology, driving increased clinical utility. We review recent developments in the use of computational simulations in pediatric and congenital heart disease, describe the clinical impact in modeling in single-ventricle patients, and provide an overview of emerging areas. RECENT FINDINGS Multiscale modeling combining patient-specific hemodynamics with reduced order (i.e., mathematically and computationally simplified) circulatory models has become the de-facto standard for modeling local hemodynamics and 'global' circulatory physiology. We review recent advances that have enabled faster solutions, discuss new methods (e.g., fluid structure interaction and uncertainty quantification), which lend realism both computationally and clinically to results, highlight novel computationally derived surgical methods for single-ventricle patients, and discuss areas in which modeling has begun to exert its influence including Kawasaki disease, fetal circulation, tetralogy of Fallot (and pulmonary tree), and circulatory support. SUMMARY Computational modeling is emerging as a crucial tool for clinical decision-making and evaluation of novel surgical methods and interventions in pediatric cardiology and beyond. Continued development of modeling methods, with an eye towards clinical needs, will enable clinical adoption in a wide range of pediatric and congenital heart diseases.
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