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Gonzalez-Urquijo M, Fumagal González GA, Cárdenas Castro HM, Morales Guzman AA, Guzman Valladares AA, MacDonald DC, Moya Bencomo MD, Botello Arredondo I, Fabiani MA. Analysis of Aortic Arch Hemodynamics With Simulated Bird's Beak Effects. Vasc Endovascular Surg 2024; 58:595-601. [PMID: 38607697 DOI: 10.1177/15385744241247272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the flow effects in different degrees of thoracic aortic stent graft protrusion extension by creating bird beak effect simulations using accurate 3D geometry and a realistic, nonlinear, elastic biomechanical model using computer-aided software SolidWorks. METHODS Segmentation in 3D of an aortic arch from a computed tomography (CT) scan of a real-life patient was performed using SolidWorks. A parametric analysis of three models was performed: (A) Aortic arch with no stent, (B) 3 mm bird-beak configuration, and (C) 6.5 mm bird-beak configuration. Flow velocity, pressure, vorticity, wall shear stress (WSS), and time average WSS were assessed. RESULTS The flow velocity in Model A remained relatively constant and low in the area of the ostium of the brachiocephalic artery and doubled in the left subclavian artery. On the contrary, Models B and C showed a decrease in velocity of 52.3 % in the left subclavian artery. Furthermore, Model B showed a drop in velocity of 82.7% below the bird-beak area, whereas Model C showed a decline of 80.9% in this area. The pressure inside the supra-aortic branches was higher in Model B and C compared with Model A. In Model A, vorticity only appeared at the level of the descending aorta, with low to non-vorticity in the aortic arch. In contrast, Models B and C had an average vorticity of 241.4 Hz within the bird beak area. Regarding WSS, Model A, and Model B shared similar WSS in the peak systolic phase, in the aortic arch, and the bird beak area, whereas Model C had an increased WSS by 5 Pa on average at these zones. CONCLUSION In the present simulations' lower velocities, higher pressures, vortices, and WSS were observed around the bird beak zone, the aortic arch, and the supra-aortic vessels.
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Baturalp TB, Bozkurt S. Design and Analysis of a Polymeric Left Ventricular Simulator via Computational Modelling. Biomimetics (Basel) 2024; 9:269. [PMID: 38786479 PMCID: PMC11117906 DOI: 10.3390/biomimetics9050269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024] Open
Abstract
Preclinical testing of medical devices is an essential step in the product life cycle, whereas testing of cardiovascular implants requires specialised testbeds or numerical simulations using computer software Ansys 2016. Existing test setups used to evaluate physiological scenarios and test cardiac implants such as mock circulatory systems or isolated beating heart platforms are driven by sophisticated hardware which comes at a high cost or raises ethical concerns. On the other hand, computational methods used to simulate blood flow in the cardiovascular system may be simplified or computationally expensive. Therefore, there is a need for low-cost, relatively simple and efficient test beds that can provide realistic conditions to simulate physiological scenarios and evaluate cardiovascular devices. In this study, the concept design of a novel left ventricular simulator made of latex rubber and actuated by pneumatic artificial muscles is presented. The designed left ventricular simulator is geometrically similar to a native left ventricle, whereas the basal diameter and long axis length are within an anatomical range. Finite element simulations evaluating left ventricular twisting and shortening predicted that the designed left ventricular simulator rotates approximately 17 degrees at the apex and the long axis shortens around 11 mm. Experimental results showed that the twist angle is 18 degrees and the left ventricular simulator shortens 5 mm. Twist angles and long axis shortening as in a native left ventricle show it is capable of functioning like a native left ventricle and simulating a variety of scenarios, and therefore has the potential to be used as a test platform.
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Affiliation(s)
- Turgut Batuhan Baturalp
- Department of Mechanical Engineering, Texas Tech University, P.O. Box 41021, Lubbock, TX 79409, USA
| | - Selim Bozkurt
- School of Engineering, Ulster University, York Street, Belfast BT15 1AP, UK
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Gazo Hanna E, Younes K, Roufayel R, Khazaal M, Fajloun Z. Engineering innovations in medicine and biology: Revolutionizing patient care through mechanical solutions. Heliyon 2024; 10:e26154. [PMID: 38390063 PMCID: PMC10882044 DOI: 10.1016/j.heliyon.2024.e26154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The overlap between mechanical engineering and medicine is expanding more and more over the years. Engineers are now using their expertise to design and create functional biomaterials and are continually collaborating with physicians to improve patient health. In this review, we explore the state of scientific knowledge in the areas of biomaterials, biomechanics, nanomechanics, and computational fluid dynamics (CFD) in relation to the pharmaceutical and medical industry. Focusing on current research and breakthroughs, we provide an overview of how these fields are being used to create new technologies for medical treatments of human patients. Barriers and constraints in these fields, as well as ways to overcome them, are also described in this review. Finally, the potential for future advances in biomaterials to fundamentally change the current approach to medicine and biology is also discussed.
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Affiliation(s)
- Eddie Gazo Hanna
- College of Engineering and Technology, American University of the Middle East, Egaila, 54200, Kuwait
| | - Khaled Younes
- College of Engineering and Technology, American University of the Middle East, Egaila, 54200, Kuwait
| | - Rabih Roufayel
- College of Engineering and Technology, American University of the Middle East, Egaila, 54200, Kuwait
| | - Mickael Khazaal
- École Supérieure des Techniques Aéronautiques et de Construction Automobile, ISAE-ESTACA, France
| | - Ziad Fajloun
- Faculty of Sciences 3, Department of Biology, Lebanese University, Campus Michel Slayman Ras Maska, 1352, Tripoli, Lebanon
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and Its Applications, EDST, Lebanese University, 1300, Tripoli, Lebanon
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Baenen O, Carreño-Martínez AC, Abraham TP, Rugonyi S. Energetics of Cardiac Blood Flow in Hypertrophic Cardiomyopathy through Individualized Computational Modeling. J Cardiovasc Dev Dis 2023; 10:411. [PMID: 37887858 PMCID: PMC10607792 DOI: 10.3390/jcdd10100411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a congenital heart disease characterized by thickening of the heart's left ventricle (LV) wall that can lead to cardiac dysfunction and heart failure. Ventricular wall thickening affects the motion of cardiac walls and blood flow within the heart. Because abnormal cardiac blood flow in turn could lead to detrimental remodeling of heart walls, aberrant ventricular flow patterns could exacerbate HCM progression. How blood flow patterns are affected by hypertrophy and inter-patient variability is not known. To address this gap in knowledge, we present here strategies to generate personalized computational fluid dynamics (CFD) models of the heart LV from patient cardiac magnetic resonance (cMR) images. We performed simulations of CFD LV models from three cases (one normal, two HCM). CFD computations solved for blood flow velocities, from which flow patterns and the energetics of flow within the LV were quantified. We found that, compared to a normal heart, HCM hearts exhibit anomalous flow patterns and a mismatch in the timing of energy transfer from the LV wall to blood flow, as well as changes in kinetic energy flow patterns. While our results are preliminary, our presented methodology holds promise for in-depth analysis of HCM patient hemodynamics in clinical practice.
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Affiliation(s)
- Owen Baenen
- Department of Mechanical Engineering, Rice University, Houston, TX 77005, USA;
- Biomedical Engineering Department, Oregon Health & Science University, Portland, OR 97239, USA
| | - Angie Carolina Carreño-Martínez
- USCF HCM Center, Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA 94158, USA (T.P.A.)
| | - Theodore P. Abraham
- USCF HCM Center, Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA 94158, USA (T.P.A.)
| | - Sandra Rugonyi
- Biomedical Engineering Department, Oregon Health & Science University, Portland, OR 97239, USA
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5
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El Sayed R, Sharifi A, Park CC, Haussen DC, Allen JW, Oshinski JN. Optimization of 4D Flow MRI Spatial and Temporal Resolution for Examining Complex Hemodynamics in the Carotid Artery Bifurcation. Cardiovasc Eng Technol 2023; 14:476-488. [PMID: 37156900 PMCID: PMC10524741 DOI: 10.1007/s13239-023-00667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Three-dimensional, ECG-gated, time-resolved, three-directional, velocity-encoded phase-contrast MRI (4D flow MRI) has been applied extensively to measure blood velocity in great vessels but has been much less used in diseased carotid arteries. Carotid artery webs (CaW) are non-inflammatory intraluminal shelf-like projections into the internal carotid artery (ICA) bulb that are associated with complex flow and cryptogenic stroke. PURPOSE Optimize 4D flow MRI for measuring the velocity field of complex flow in the carotid artery bifurcation model that contains a CaW. METHODS A 3D printed phantom model created from computed tomography angiography (CTA) of a subject with CaW was placed in a pulsatile flow loop within the MRI scanner. 4D Flow MRI images of the phantom were acquired with five different spatial resolutions (0.50-2.00 mm3) and four different temporal resolutions (23-96 ms) and compared to a computational fluid dynamics (CFD) solution of the flow field as a reference. We examined four planes perpendicular to the vessel centerline, one in the common carotid artery (CCA) and three in the internal carotid artery (ICA) where complex flow was expected. At these four planes pixel-by-pixel velocity values, flow, and time average wall shear stress (TAWSS) were compared between 4D flow MRI and CFD. HYPOTHESIS An optimized 4D flow MRI protocol will provide a good correlation with CFD velocity and TAWSS values in areas of complex flow within a clinically feasible scan time (~ 10 min). RESULTS Spatial resolution affected the velocity values, time average flow, and TAWSS measurements. Qualitatively, a spatial resolution of 0.50 mm3 resulted in higher noise, while a lower spatial resolution of 1.50-2.00 mm3 did not adequately resolve the velocity profile. Isotropic spatial resolutions of 0.50-1.00 mm3 showed no significant difference in total flow compared to CFD. Pixel-by-pixel velocity correlation coefficients between 4D flow MRI and CFD were > 0.75 for 0.50-1.00 mm3 but were < 0.5 for 1.50 and 2.00 mm3. Regional TAWSS values determined from 4D flow MRI were generally lower than CFD and decreased at lower spatial resolutions (larger pixel sizes). TAWSS differences between 4D flow and CFD were not statistically significant at spatial resolutions of 0.50-1.00 mm3 but were different at 1.50 and 2.00 mm3. Differences in temporal resolution only affected the flow values when temporal resolution was > 48.4 ms; temporal resolution did not affect TAWSS values. CONCLUSION A spatial resolution of 0.74-1.00 mm3 and a temporal resolution of 23-48 ms (1-2 k-space segments) provides a 4D flow MRI protocol capable of imaging velocity and TAWSS in regions of complex flow within the carotid bifurcation at a clinically acceptable scan time.
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Affiliation(s)
- Retta El Sayed
- Department of Biomedical Engineering, The Wallace H. Coulter, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - Alireza Sharifi
- Department of Radiology & Imaging Sciences, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA
| | - Charlie C Park
- Department of Radiology & Imaging Sciences, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA
| | | | - Jason W Allen
- Department of Biomedical Engineering, The Wallace H. Coulter, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
- Department of Radiology & Imaging Sciences, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - John N Oshinski
- Department of Biomedical Engineering, The Wallace H. Coulter, Emory University and Georgia Institute of Technology, Atlanta, GA, USA.
- Department of Radiology & Imaging Sciences, Emory University, 1364 Clifton Rd, Atlanta, GA, 30322, USA.
- Department of Neurology, Emory University, Atlanta, GA, USA.
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Venn J, Larkee CE, Garcia GJM, Rayz VL, LaDisa JF. A workflow for viewing biomedical computational fluid dynamics results and corresponding data within virtual and augmented reality environments. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1096289. [PMID: 36908292 PMCID: PMC9996009 DOI: 10.3389/fmedt.2023.1096289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/26/2023] [Indexed: 02/25/2023] Open
Abstract
Researchers conducting computational fluid dynamics (CFD) modeling can spend weeks obtaining imaging data, determining boundary conditions, running simulations and post-processing files. However, results are typically viewed on a 2D display and often at one point in time thus reducing the dynamic and inherently three-dimensional data to a static image. Results from different pathologic states or cases are rarely compared in real-time, and supplementary data are seldom included. Therefore, only a fraction of CFD results are typically studied in detail, and associations between mechanical stimuli and biological response may be overlooked. Virtual and augmented reality facilitate stereoscopic viewing that may foster extraction of more information from CFD results by taking advantage of improved depth cues, as well as custom content development and interactivity, all within an immersive approach. Our objective was to develop a straightforward, semi-automated workflow for enhanced viewing of CFD results and associated data in an immersive virtual environment (IVE). The workflow supports common CFD software and has been successfully completed by novice users in about an hour, demonstrating its ease of use. Moreover, its utility is demonstrated across clinical research areas and IVE platforms spanning a range of cost and development considerations. We are optimistic that this advancement, which decreases and simplifies the steps to facilitate more widespread use of immersive CFD viewing, will foster more efficient collaboration between engineers and clinicians. Initial clinical feedback is presented, and instructional videos, manuals, templates and sample data are provided online to facilitate adoption by the community.
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Affiliation(s)
- John Venn
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Guilherme J. M. Garcia
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
| | - Vitaliy L. Rayz
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - John F. LaDisa
- Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Pediatrics - Division of Cardiology, Herma Heart Institute, Children’s Wisconsin and the Medical College of Wisconsin, Milwaukee, WI, United States
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Williamson PN, Docherty PD, Yazdi SG, Khanafer A, Kabaliuk N, Jermy M, Geoghegan PH. Review of the Development of Hemodynamic Modeling Techniques to Capture Flow Behavior in Arteries Affected by Aneurysm, Atherosclerosis, and Stenting. J Biomech Eng 2022; 144:1128816. [PMID: 34802061 DOI: 10.1115/1.4053082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Indexed: 02/05/2023]
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in the developed world. CVD can include atherosclerosis, aneurysm, dissection, or occlusion of the main arteries. Many CVDs are caused by unhealthy hemodynamics. Some CVDs can be treated with the implantation of stents and stent grafts. Investigations have been carried out to understand the effects of stents and stent grafts have on arteries and the hemodynamic changes post-treatment. Numerous studies on stent hemodynamics have been carried out using computational fluid dynamics (CFD) which has yielded significant insight into the effect of stent mesh design on near-wall blood flow and improving hemodynamics. Particle image velocimetry (PIV) has also been used to capture behavior of fluids that mimic physiological hemodynamics. However, PIV studies have largely been restricted to unstented models or intra-aneurysmal flow rather than peri or distal stent flow behaviors. PIV has been used both as a standalone measurement method and as a comparison to validate the CFD studies. This article reviews the successes and limitations of CFD and PIV-based modeling methods used to investigate the hemodynamic effects of stents. The review includes an overview of physiology and relevant mechanics of arteries as well as consideration of boundary conditions and the working fluids used to simulate blood for each modeling method along with the benefits and limitations introduced.
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Affiliation(s)
- Petra N Williamson
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Paul D Docherty
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Sina G Yazdi
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Adib Khanafer
- Vascular, Endovascular, and Renal Transplant Unit, Christchurch Hospital, Canterbury District Health Board, Riccarton Avenue, Christchurch 8053, New Zealand; Christchurch School of Medicine, University of Otago, Dunedin 9016, New Zealand
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Mark Jermy
- Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Patrick H Geoghegan
- School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK; Department of Mechanical and Industrial Engineering, University of South Africa, Johannesburg 2006, South Africa
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Singh V, Garg A, Dewangan HK. Recent Advances in Drug Design and Delivery Across Biological Barriers using Computational Models. LETT DRUG DES DISCOV 2022. [DOI: 10.2174/1570180819999220204110306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract:
The systemic delivery of pharmacological substances generally exhibits several significant limitations associated with the bio-distribution of active drugs in the body. As per consequence, human body’s defense mechanisms become impediments to drug delivery. Various technologies to overcome these limitations have been evolved including computational approaches and advanced drug delivery. As the body of human has evolved to defend itself from hostile biological as well as chemical invaders, along with that these biological barriers such as ocular barriers, blood-brain barriers, intestinal and skin barriers also limit the passage of drugs across desired sites. Therefore, efficient delivery remains an utmost challenge for researchers and scientists. The present review focuses on the techniques to deliver the drugs with efficient therapeutic efficacy at the targeted sites. This review article considered the insights into main biological barriers along with the application of computational or numerical methods dealing with different barriers by determining the drug flow, temperature and various other parameters. It also summarizes the advanced implantable drug delivery system to circumvent the inherent resistance showed by these biological barriers and in turn to improve the drug delivery.
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Affiliation(s)
- Vanshita Singh
- Institute of Pharmaceutical Research, GLA University Mathura, NH-2 Delhi Mathura Road, PO-Chaumuhan, Mathura, UttarPradesh, India 281406
| | - Akash Garg
- Institute of Pharmaceutical Research, GLA University Mathura, NH-2 Delhi Mathura Road, PO-Chaumuhan, Mathura, UttarPradesh, India 281406
| | - Hitesh Kumar Dewangan
- University Institute of Pharma Sciences (UIPS), Chandigarh University NH-95, Chandigarh Ludhiyana Highway, Mohali Punjab, India
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9
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Du J, Shi J, Liu J, Deng C, Shen J, Wang Q. Hemodynamic analysis of hepatic arteries for the early evaluation of hepatic fibrosis in biliary atresia. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 211:106400. [PMID: 34551379 DOI: 10.1016/j.cmpb.2021.106400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Hepatic fibrosis is the prominent characteristic of biliary atresia (BA), may even progress continually after Kasai procedure (KP). BA, as a devastating pediatric hepatic disease, mainly leads to newborn cholestasis, even liver cirrhosis, eventually hepatic failure. Earlier diagnosis of hepatic fibrosis, which used to be detected by liver biopsy commonly, is consistent with better outcomes of KP. Due to potential risks and uncertainty of liver biopsy, it is an urge to seek a safer and more precise evaluation method as alternative. The purpose of this study is to investigate the hemodynamics of hepatic artery (HA) in hepatic fibrosis of early BA based on computational fluid dynamics (CFD) for evaluating the value of CFD for hepatic fibrosis diagnosis. METHODS 40 patients were divided into three groups, including the control group, the abnormal liver function group and the mild to moderate hepatic fibrosis group. CFD was applied to quantify primary hemodynamic parameters of HA and related arteries, including blood flow distribution ratio (FDR), pressure, wall shear stress (WSS) and energy loss (EL). Statistical analyses were also performed to compare the differences amongst these above groups. RESULTS With the progression of hepatic fibrosis, the increasing tendency of hemodynamic parameters values of HA and related arteries were observed. Values of FDR, pressure, WSS and EL of the mild to moderate group was higher than those of the control group and the abnormal liver function group. There were significant differences on FDRAA, FDRHA and EL between the control group and the mild to moderate hepatic fibrosis group (t = 0.037, 0.030 and <0.001, P < 0.05). CONCLUSION Significant variations of HA hemodynamics acquired by CFD between the control group and the mild to moderate hepatic fibrosis group demonstrated the relationship between the progression of hepatic fibrosis and the hemodynamic disorder, and suggested that CFD had the potential to assist the diagnosis of hepatic fibrosis in early BA.
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Affiliation(s)
- Jun Du
- Department of Medical Imaging, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai 200127, China
| | - Jing Shi
- Department of Medical Imaging, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai 200127, China
| | - Jinlong Liu
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaohui Deng
- Department of Gastroenterology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juanya Shen
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Wang
- Department of Medical Imaging, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Shanghai 200127, China.
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10
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Athani A, Ghazali NNN, Badruddin IA, Kamangar S, Anqi AE, Algahtani A. Investigation of two-way fluid-structure interaction of blood flow in a patient-specific left coronary artery. Biomed Mater Eng 2021; 33:13-30. [PMID: 34366314 DOI: 10.3233/bme-201171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The blood flow in the human artery has been a subject of sincere interest due to its prime importance linked with human health. The hemodynamic study has revealed an essential aspect of blood flow that eventually proved to be paramount to make a correct decision to treat patients suffering from cardiac disease. OBJECTIVE The current study aims to elucidate the two-way fluid-structure interaction (FSI) analysis of the blood flow and the effect of stenosis on hemodynamic parameters. METHODS A patient-specific 3D model of the left coronary artery was constructed based on computed tomography (CT) images. The blood is assumed to be incompressible, homogenous, and behaves as Non-Newtonian, while the artery is considered as a nonlinear elastic, anisotropic, and incompressible material. Pulsatile flow conditions were applied at the boundary. Two-way coupled FSI modeling approach was used between fluid and solid domain. The hemodynamic parameters such as the pressure, velocity streamline, and wall shear stress were analyzed in the fluid domain and the solid domain deformation. RESULTS The simulated results reveal that pressure drop exists in the vicinity of stenosis and a recirculation region after the stenosis. It was noted that stenosis leads to high wall stress. The results also demonstrate an overestimation of wall shear stress and velocity in the rigid wall CFD model compared to the FSI model.
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Affiliation(s)
- Abdulgaphur Athani
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - N N N Ghazali
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Irfan Anjum Badruddin
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, Asir, Kingdom Saudi Arabia.,Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, Asir, Kingdom Saudi Arabia
| | - Sarfaraz Kamangar
- Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, Asir, Kingdom Saudi Arabia
| | - Ali E Anqi
- Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, Asir, Kingdom Saudi Arabia
| | - Ali Algahtani
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, Asir, Kingdom Saudi Arabia.,Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, Asir, Kingdom Saudi Arabia
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11
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Quan X, Liu J, Roxlo T, Siddharth S, Leong W, Muir A, Cheong SM, Rao A. Advances in Non-Invasive Blood Pressure Monitoring. SENSORS (BASEL, SWITZERLAND) 2021; 21:s21134273. [PMID: 34206457 PMCID: PMC8271585 DOI: 10.3390/s21134273] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 01/30/2023]
Abstract
This paper reviews recent advances in non-invasive blood pressure monitoring and highlights the added value of a novel algorithm-based blood pressure sensor which uses machine-learning techniques to extract blood pressure values from the shape of the pulse waveform. We report results from preliminary studies on a range of patient populations and discuss the accuracy and limitations of this capacitive-based technology and its potential application in hospitals and communities.
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Affiliation(s)
- Xina Quan
- PyrAmes Inc., Cupertino, CA 95014, USA; (J.L.); (T.R.); (S.S.); (W.L.); (A.M.)
- Correspondence: ; Tel.: +1-408-216-0099
| | - Junjun Liu
- PyrAmes Inc., Cupertino, CA 95014, USA; (J.L.); (T.R.); (S.S.); (W.L.); (A.M.)
| | - Thomas Roxlo
- PyrAmes Inc., Cupertino, CA 95014, USA; (J.L.); (T.R.); (S.S.); (W.L.); (A.M.)
| | - Siddharth Siddharth
- PyrAmes Inc., Cupertino, CA 95014, USA; (J.L.); (T.R.); (S.S.); (W.L.); (A.M.)
| | - Weyland Leong
- PyrAmes Inc., Cupertino, CA 95014, USA; (J.L.); (T.R.); (S.S.); (W.L.); (A.M.)
| | - Arthur Muir
- PyrAmes Inc., Cupertino, CA 95014, USA; (J.L.); (T.R.); (S.S.); (W.L.); (A.M.)
| | - So-Min Cheong
- Department of Geography & Atmospheric Science, University of Kansas, Lawrence, KS 66045, USA;
| | - Anoop Rao
- Department of Pediatrics, Neonatology, Stanford University, Palo Alto, CA 94304, USA;
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12
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Zhang H, Li L, Miao F, Yu J, Zhou B, Pan Y. Computational fluid dynamics analysis of intracranial aneurysms treated with flow diverters: A case report. Neurochirurgie 2021; 68:235-238. [PMID: 33771614 DOI: 10.1016/j.neuchi.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/05/2021] [Accepted: 03/06/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Intracranial aneurysms (IAs) are localized dilatations of intracranial arteries due to weaknesses of the endothelial layer. IAs may be treated by flow diverters (FDs), alternatively to stents and coils combination. FD is a method for the treatment of IAs especially for large, wide-necked or fusiform aneurysms. In this case report, we described a 65-year-old woman with IA who were treated by FD. CASE PRESENTATION A 65-year-old woman was diagnosed with a giant aneurysm at the posterior inferior cerebellar artery segment of the left internal carotid artery. Then based on the computed tomography data of this woman, aneurysm vascular stent model was constructed before and after FD, and internal pressure, velocity, wall shear stress (WSS) of aneurysms were determined by CFD analysis. Standard boundary conditions were applied. It was found that a single FD stent and double FD stents decreased the blood flow and WSS of aneurysm. The effect of single FD stent+30% filling on blood flow was more obvious, but the aneurysm rupture was caused by excessive coil packing. So, a single stent+10% coil packing rate was the best option for treating aneurysms. CONCLUSIONS CFD analysis for flow velocity and WSS have protection on aneurysms.
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Affiliation(s)
- H Zhang
- Department of Neurosurgery, Lanzhou University Second Hospital, 80, Cuiyingmen Road, Chengguan District, 730030 Lanzhou City, Gansu Province, China
| | - L Li
- School of Clinical Medicine, Gansu University of Chinese Medicine, 730030 Lanzhou, China
| | - F Miao
- Department of Neurosurgery, Zhangye People's Hospital Affiliated to Hexi University, 734000 Zhangye, China
| | - J Yu
- College of Petroleum and Chemical Engineering, Lanzhou University of Technology, 730050 Lanzhou, China
| | - B Zhou
- Department of Neurosurgery, Lanzhou University Second Hospital, 80, Cuiyingmen Road, Chengguan District, 730030 Lanzhou City, Gansu Province, China
| | - Y Pan
- Department of Neurosurgery, Lanzhou University Second Hospital, 80, Cuiyingmen Road, Chengguan District, 730030 Lanzhou City, Gansu Province, China.
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13
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Kamali Shahri SM, Contarino C, Chifari F, Mahmoudi M, Gelman S. Function of arteries and veins in conditions of simulated cardiac arrest. ACTA ACUST UNITED AC 2021; 11:157-164. [PMID: 33842286 PMCID: PMC8022231 DOI: 10.34172/bi.2021.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/17/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022]
Abstract
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Introduction: The study examined the behavior of vasculature in conditions of eliminated cardiac function using mathematical modeling. In addition, we addressed the question of whether the stretch-recoil capability of veins, at least in part accounts for the slower response to simulated cardiac arrest. Methods: In the first set of computational experiments, blood flow and pressure patterns in veins and arteries during the first few seconds after cardiac arrest were assessed via a validated multi-scale mathematical model of the whole cardiovascular system, comprising cardiac dynamics, arterial and venous blood flow dynamics, and microcirculation. In the second set of experiments, the effects of stretch-recoil zones of venous vessels with different diameters and velocities on blood velocity and dynamic pressure analyzed using computational fluid dynamics (CFD) modeling. Results: In the first set of experiments, measurement of changes in velocity, dynamic pressure, and fluid flow revealed that the venous system responded to cardiac arrest more slowly compared to the arteries. This disparity might be due to the intrinsic characteristics of the venous system, including stretch-recoil and elastic fiber composition. In the second set of experiments, we attempted to determine the role of the stretch-recoil capability of veins in the slower response to cardiac arrest. During the second set of experiments, we found that this recoil behavior increased dynamic pressure, velocity, and blood flow. The enhancement in dynamic pressure through combining the results from both experiments yielded a 15-40% increase in maximum dynamic pressure due to stretch-recoil, depending on vein diameter under normal conditions. Conclusion: In the situation of cardiac arrest, the vein geometry changes continue, promoting smooth responses of the venous system. Moreover, the importance of such vein behavior in blood displacement may grow as the pressure on the venous side gradually decreases with time. Our experiments suggest that the driving force for venous return is the pressure difference that remains within the venous system after the energy coming from every ventricular systole spent to overcome the resistance created by arterial and capillary systems.
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Affiliation(s)
- Seyed Mehdi Kamali Shahri
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, MA, USA
| | | | | | - Morteza Mahmoudi
- Precision Health Program and Department of Radiology, Michigan State University, MI, USA
| | - Simon Gelman
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, MA, USA
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14
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Liu J, Chen Y, Xiong Y, Chen X, Duan Y, Yang Y. Computational hemodynamics study of anterior communicating artery aneurysm associated with fenestration: A case report. INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT 2020. [DOI: 10.1016/j.inat.2019.100563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Thrust Prediction of an Active Flapping Foil in Waves Using CFD. JOURNAL OF MARINE SCIENCE AND ENGINEERING 2019. [DOI: 10.3390/jmse7110396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A horizontally submerged passive flapping foil can generate thrust force against the wave propagation using wave energy. This renewable method has been used for the design of propulsion and maneuvering systems of ships and other floating structures. Recently, the passive flapping foils were applied to design the station-keeping system of deep-water floaters. Studies proved that the passively flapping foil system was ineffective in short waves and drift of the floater beyond the design limit was recorded. Therefore, an active flapping foil was investigated as a potential solution to this problem. A computational fluid dynamics (CFD) numerical tool “ANSYS Workbench 19.2” was used to predict the thrust force generated by the active flapping foil in a short wave. Results proved that the active flapping foil can effectively convert wave energy into propulsive energy in short waves and the magnitude of the thrust force depends on the flapping frequency.
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16
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Armstrong AK, Zampi JD, Itu LM, Benson LN. Use of 3D rotational angiography to perform computational fluid dynamics and virtual interventions in aortic coarctation. Catheter Cardiovasc Interv 2019; 95:294-299. [PMID: 31609061 DOI: 10.1002/ccd.28507] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/16/2019] [Accepted: 09/10/2019] [Indexed: 12/23/2022]
Abstract
Computational fluid dynamics (CFD) can be used to analyze blood flow and to predict hemodynamic outcomes after interventions for coarctation of the aorta and other cardiovascular diseases. We report the first use of cardiac 3-dimensional rotational angiography for CFD and show not only feasibility but also validation of its hemodynamic computations with catheter-based measurements in three patients.
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Affiliation(s)
| | - Jeffrey D Zampi
- The Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan
| | - Lucian M Itu
- Department of Corporate Technology, Siemens SRL, Brasov, Romania and Department of Automation and Information Technology, Transylvania University of Brasov, Brasov, Romania
| | - Lee N Benson
- The Division of Cardiology, The Labatt Family Heart Center, The Hospital for Sick Children, Toronto, Canada
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17
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Acuna A, Berman AG, Damen FW, Meyers BA, Adelsperger AR, Bayer KC, Brindise MC, Bungart B, Kiel AM, Morrison RA, Muskat JC, Wasilczuk KM, Wen Y, Zhang J, Zito P, Goergen CJ. Computational Fluid Dynamics of Vascular Disease in Animal Models. J Biomech Eng 2019; 140:2676341. [PMID: 29570754 DOI: 10.1115/1.4039678] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Indexed: 12/19/2022]
Abstract
Recent applications of computational fluid dynamics (CFD) applied to the cardiovascular system have demonstrated its power in investigating the impact of hemodynamics on disease initiation, progression, and treatment outcomes. Flow metrics such as pressure distributions, wall shear stresses (WSS), and blood velocity profiles can be quantified to provide insight into observed pathologies, assist with surgical planning, or even predict disease progression. While numerous studies have performed simulations on clinical human patient data, it often lacks prediagnosis information and can be subject to large intersubject variability, limiting the generalizability of findings. Thus, animal models are often used to identify and manipulate specific factors contributing to vascular disease because they provide a more controlled environment. In this review, we explore the use of CFD in animal models in recent studies to investigate the initiating mechanisms, progression, and intervention effects of various vascular diseases. The first section provides a brief overview of the CFD theory and tools that are commonly used to study blood flow. The following sections are separated by anatomical region, with the abdominal, thoracic, and cerebral areas specifically highlighted. We discuss the associated benefits and obstacles to performing CFD modeling in each location. Finally, we highlight animal CFD studies focusing on common surgical treatments, including arteriovenous fistulas (AVF) and pulmonary artery grafts. The studies included in this review demonstrate the value of combining CFD with animal imaging and should encourage further research to optimize and expand upon these techniques for the study of vascular disease.
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Affiliation(s)
- Andrea Acuna
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Alycia G Berman
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Frederick W Damen
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Brett A Meyers
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 e-mail:
| | - Amelia R Adelsperger
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Kelsey C Bayer
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Melissa C Brindise
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 e-mail:
| | - Brittani Bungart
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Alexander M Kiel
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Rachel A Morrison
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Joseph C Muskat
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Kelsey M Wasilczuk
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Yi Wen
- Department of Agricultural and Biological Engineering, Purdue University, 225 South University Street, West Lafayette, IN 47907 e-mail:
| | - Jiacheng Zhang
- School of Mechanical Engineering, Purdue University, 585 Purdue Mall, West Lafayette, IN 47907 e-mail:
| | - Patrick Zito
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
| | - Craig J Goergen
- ASME Membership Bioengineering Division, Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, IN 47907 e-mail:
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18
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Mohammad Fauzi AH, Saifuddin MNAA, Kasim FH, Abu Bakar MH, Zakaria ZY, Abu Bakar MZ. Simulation of Crude Palm Oil Dilution in a Palm Oil Mill Using Computational Fluid Dynamics. Chem Eng Technol 2019. [DOI: 10.1002/ceat.201800648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ahmad Hafiidz Mohammad Fauzi
- Universiti Malaysia PerlisSchool of Bioprocess Engineering Kompleks Pusat Pengajian Jejawi 3, Kawasan Perindustrian Jejawi 02600 Arau, Perlis Malaysia
- Universiti Malaysia PerlisCentre of Excellence for Biomass Engineering, School of Bioprocess Engineering Kompleks Pusat Pengajian Jejawi 3, Kawasan Perindustrian Jejawi 02600 Arau, Perlis Malaysia
| | - Md Nabil Ab Adzim Saifuddin
- Universiti Malaysia PerlisSchool of Bioprocess Engineering Kompleks Pusat Pengajian Jejawi 3, Kawasan Perindustrian Jejawi 02600 Arau, Perlis Malaysia
- Universiti Malaysia PerlisCentre of Excellence for Biomass Engineering, School of Bioprocess Engineering Kompleks Pusat Pengajian Jejawi 3, Kawasan Perindustrian Jejawi 02600 Arau, Perlis Malaysia
| | - Farizul Hafiz Kasim
- Universiti Malaysia PerlisSchool of Bioprocess Engineering Kompleks Pusat Pengajian Jejawi 3, Kawasan Perindustrian Jejawi 02600 Arau, Perlis Malaysia
- Universiti Malaysia PerlisCentre of Excellence for Biomass Engineering, School of Bioprocess Engineering Kompleks Pusat Pengajian Jejawi 3, Kawasan Perindustrian Jejawi 02600 Arau, Perlis Malaysia
| | - Muhamad Husaini Abu Bakar
- Universiti Kuala LumpurMalaysian Spanish Institute, System Engineering and Energy Laboratory Kulim Hi-Tech Park 09000 Kulim, Kedah Malaysia
| | - Zaki Yamani Zakaria
- Universiti Teknologi MalaysiaDepartment of Chemical Engineering, Faculty of Chemical and Energy Engineering 81310 Johor Bahru, Johor Malaysia
| | - Mohamad Zailani Abu Bakar
- Universiti Sains MalaysiaSchool of Chemical Engineering, Engineering Campus Seri Ampangan, Seberang Prai Selatan 14300 Nibong Tebal, Penang Malaysia
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19
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Tucker T. Fluid dynamics of thoracic cavity venous flow in multiple sclerosis. Med Hypotheses 2019; 131:109236. [PMID: 31443776 DOI: 10.1016/j.mehy.2019.109236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/15/2019] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
This paper hypothesizes, based on fluid dynamics principles, that in multiple sclerosis (MS) non-laminar, vortex blood flow occurs in the superior vena cava (SVC) and brachiocephalic veins (BVs), particularly at junctions with their tributary veins. The physics-based analysis demonstrates that the morphology and physical attributes of the major thoracic veins, and their tributary confluent veins, together with the attributes of the flowing blood, predict transition from laminar to non-laminar flow, primarily vortex flow, at select vein curvatures and junctions. Non-laminar, vortex flow results in the development of immobile stenotic valves and intraluminal flow obstructions, particularly in the internal jugular veins (IJVs) and in the azygos vein (AV) at their confluences with the SVC or BVs. Clinical trials' observations of vascular flow show that regions of low and reversing flow are associated with endothelial malformation. The physics-based analysis predicts the growth of intraluminal flaps and septa at segments of vein curvature and flow confluences. The analysis demonstrates positive correlations between predicted and clinically observed elongation of valve leaflets and between the predicted and observed prevalence of immobile valves at various venous flow confluences. The analysis predicts the formation of sclerotic plaques at venous junctions and curvatures, in locations that are analogous to plaques in atherosclerosis. The analysis predicts that increasing venous compliance increases the laminarity of venous flow and reduces the prevalence and severity of vein malformations and plaques, a potentially significant clinical result. An over-arching observation is that the correlations between predicted phenomena and clinically observed phenomena are sufficiently positive that the physics-based approach represents a new means for understanding the relationships between venous flow in MS and clinically observed venous malformations.
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20
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Algabri YA, Altwijri O, Chatpun S. Visualization of Blood Flow in AAA Patient-Specific Geometry: 3-D Reconstruction and Simulation Procedures. BIONANOSCIENCE 2019. [DOI: 10.1007/s12668-019-00662-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Thaker R, Araujo-Gutierrez R, Marcos-Abdala HG, Agrawal T, Fida N, Kassi M. Innovative Modeling Techniques and 3D Printing in Patients with Left Ventricular Assist Devices: A Bridge from Bench to Clinical Practice. J Clin Med 2019; 8:E635. [PMID: 31075841 PMCID: PMC6572374 DOI: 10.3390/jcm8050635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 04/24/2019] [Accepted: 05/01/2019] [Indexed: 02/07/2023] Open
Abstract
Left ventricular assist devices (LVAD) cause altered flow dynamics that may result in complications such as stroke, pump thrombosis, bleeding, or aortic regurgitation. Understanding altered flow dynamics is important in order to develop more efficient and durable pump configurations. In patients with LVAD, hemodynamic assessment is limited to imaging techniques such as echocardiography which precludes detailed assessment of fluid dynamics. In this review article, we present some innovative modeling techniques that are often used in device development or for research purposes, but have not been utilized clinically. Computational fluid dynamic (CFD) modeling is based on computer simulations and particle image velocimetry (PIV) employs ex vivo models that helps study fluid characteristics such as pressure, shear stress, and velocity. Both techniques may help elaborate our understanding of complications that occur with LVAD and could be potentially used in the future to troubleshoot LVAD-related alarms. These techniques coupled with 3D printing may also allow for patient-specific device implants, lowering the risk of complications increasing device durability.
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Affiliation(s)
- Rishi Thaker
- Touro College of Osteopathic Medicine, Middletown, New York, NY 10940, USA.
| | - Raquel Araujo-Gutierrez
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Hernan G Marcos-Abdala
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Tanushree Agrawal
- Department of Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Nadia Fida
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Mahwash Kassi
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
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22
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Van Holsbeke C, De Backer J, Vos W, Marshall J. Use of functional respiratory imaging to characterize the effect of inhalation profile and particle size on lung deposition of inhaled corticosteroid/long-acting β2-agonists delivered via a pressurized metered-dose inhaler. Ther Adv Respir Dis 2019; 12:1753466618760948. [PMID: 29499614 PMCID: PMC5937159 DOI: 10.1177/1753466618760948] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Functional respiratory imaging (FRI) uses three-dimensional models of human lungs and computational fluid dynamics to simulate functional changes within airways and predict the deposition of inhaled drugs. This study used FRI to model the effects of different patient inhalation and drug formulation factors on lung deposition of an inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combination, administered by a pressurized metered-dose inhaler. Methods: Three-dimensional models of the lungs of six patients with asthma (mean forced expiratory volume in 1 s, 83%), treated with an ICS/LABA, were included. FRI modelling was used to simulate (1) the effects on lung deposition of inhalation duration and particle size [fine particle fraction (FPF), proportion of particles <5 µm; and mass median aerodynamic diameter (MMAD), average size of inhalable particles]; (2) deposition of fluticasone propionate/formoterol (FP/FORM) 125/5 µg; and (3) how inhalation profiles and flow rates affected FP/FORM deposition. Results: Total lung depositions (TLDs) following 1-, 3- and 5-s inhalations were 22.8%, 36.1% and 41.6% (metered dose), respectively, and central-to-peripheral deposition (C:P) ratios were 1.81, 0.86 and 0.61, respectively. TLD increased with increasing FPF, from ~8% at 10% FPF to ~36% at 40% FPF (metered dose); by contrast, MMAD had little effect on TLD, which was similar across MMADs (1.5–4.5 µm) at each FPF. FP/FORM deposited throughout central and peripheral airways with gradual (sinusoidal) and sharp (rapid) inhalations. TLD ranged from 35.8 to 44.0% (metered dose) for gradual and sharp inhalations at 30 and 60 L/min mean flow rates. Conclusions: These data provide important insights into the potential effects of inhalation characteristics (inhalation profile and duration) and aerosol formulation (FPF) on lung deposition of inhaled therapies. FRI thus represents a useful alternative to scintigraphy techniques. Future FRI studies will further our understanding of the deposition of inhaled drugs and help improve the management of asthma.
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Affiliation(s)
| | | | - Wim Vos
- FLUIDDA NV, Kontich, Belgium
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23
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Riveros Perez E, Riveros R. Mathematical Analysis and Physical Profile of Blalock-Taussig Shunt and Sano Modification Procedure in Hypoplastic Left Heart Syndrome: Review of the Literature and Implications for the Anesthesiologist. Semin Cardiothorac Vasc Anesth 2017; 21:152-164. [PMID: 28118786 DOI: 10.1177/1089253216687857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The first stage of surgical treatment for hypoplastic left heart syndrome (HLHS) includes the creation of artificial systemic-to-pulmonary connections to provide pulmonary blood flow. The modified Blalock-Taussig (mBT) shunt has been the technique of choice for this procedure; however, a right ventricle-pulmonary artery (RV-PA) shunt has been introduced into clinical practice with encouraging but still conflicting outcomes when compared with the mBT shunt. The aim of this study is to explore mathematical modeling as a tool for describing physical profiles that could assist the surgical team in predicting complications related to stenosis and malfunction of grafts in an attempt to find correlations with clinical outcomes from clinical studies that compared both surgical techniques and to assist the anesthesiologist in making decisions to manage patients with this complex cardiac anatomy. Mathematical modeling to display the physical characteristics of the chosen surgical shunt is a valuable tool to predict flow patterns, shear stress, and rate distribution as well as energetic performance at the graft level and relative to ventricular efficiency. Such predictions will enable the surgical team to refine the technique so that hemodynamic complications be anticipated and prevented, and are also important for perioperative management by the anesthesia team.
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Negin Mortazavi S, Geddes D, Hassanipour F. Lactation in the Human Breast From a Fluid Dynamics Point of View. J Biomech Eng 2016; 139:2571656. [DOI: 10.1115/1.4034995] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Indexed: 11/08/2022]
Abstract
This study is a collaborative effort among lactation specialists and fluid dynamic engineers. The paper presents clinical results for suckling pressure pattern in lactating human breast as well as a 3D computational fluid dynamics (CFD) modeling of milk flow using these clinical inputs. The investigation starts with a careful, statistically representative measurement of suckling vacuum pressure, milk flow rate, and milk intake in a group of infants. The results from clinical data show that suckling action does not occur with constant suckling rate but changes in a rhythmic manner for infants. These pressure profiles are then used as the boundary condition for the CFD study using commercial ansys fluent software. For the geometric model of the ductal system of the human breast, this work takes advantage of a recent advance in the development of a validated phantom that has been produced as a ground truth for the imaging applications for the breast. The geometric model is introduced into CFD simulations with the aforementioned boundary conditions. The results for milk intake from the CFD simulation and clinical data were compared and cross validated. Also, the variation of milk intake versus suckling pressure are presented and analyzed. Both the clinical and CFD simulation show that the maximum milk flow rate is not related to the largest vacuum pressure or longest feeding duration indicating other factors influence the milk intake by infants.
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Affiliation(s)
- S. Negin Mortazavi
- Department of Mechanical Engineering, University of Texas at Dallas, Richardson, TX 75080 e-mail:
| | - Donna Geddes
- School of Chemistry and Biochemistry, University of Western Australia, Crawley, Western Australia 6009, Australia e-mail:
| | - Fatemeh Hassanipour
- Department of Mechanical Engineering, University of Texas at Dallas, Richardson, TX 75080 e-mail:
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Knight-Schrijver V, Chelliah V, Cucurull-Sanchez L, Le Novère N. The promises of quantitative systems pharmacology modelling for drug development. Comput Struct Biotechnol J 2016; 14:363-370. [PMID: 27761201 PMCID: PMC5064996 DOI: 10.1016/j.csbj.2016.09.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/08/2016] [Accepted: 09/19/2016] [Indexed: 01/01/2023] Open
Abstract
Recent growth in annual new therapeutic entity (NTE) approvals by the U.S. Food and Drug Administration (FDA) suggests a positive trend in current research and development (R&D) output. Prior to this, the cost of each NTE was considered to be rising exponentially, with compound failure occurring mainly in clinical phases. Quantitative systems pharmacology (QSP) modelling, as an additional tool in the drug discovery arsenal, aims to further reduce NTE costs and improve drug development success. Through in silico mathematical modelling, QSP can simulate drug activity as perturbations in biological systems and thus understand the fundamental interactions which drive disease pathology, compound pharmacology and patient response. Here we review QSP, pharmacometrics and systems biology models with respect to the diseases covered as well as their clinical relevance and applications. Overall, the majority of modelling focus was aligned with the priority of drug-discovery and clinical trials. However, a few clinically important disease categories, such as Immune System Diseases and Respiratory Tract Diseases, were poorly covered by computational models. This suggests a possible disconnect between clinical and modelling agendas. As a standard element of the drug discovery pipeline the uptake of QSP might help to increase the efficiency of drug development across all therapeutic indications.
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Affiliation(s)
| | - V. Chelliah
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SD, UK
| | | | - N. Le Novère
- Babraham Institute, Babraham Research Campus, Cambridge CB22 3AT, UK
- Corresponding author.
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26
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Ginestra PS, Ceretti E, Fiorentino A. Potential of modeling and simulations of bioengineered devices: Endoprostheses, prostheses and orthoses. Proc Inst Mech Eng H 2016; 230:607-38. [PMID: 27095509 DOI: 10.1177/0954411916643343] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 03/09/2016] [Indexed: 11/16/2022]
Abstract
Modeling and simulation of prosthetic devices are the new tools investigated for the production of total customized prostheses. Computational simulations are used to evaluate the geometrical and material designs of a device while assessing its mechanical behavior. Data acquisition through magnetic resonance imaging, computed tomography or laser scanning is the first step that gives information about the human anatomical structures; a file format has to be elaborated through computer-aided design software. Computer-aided design tools can be used to develop a device that respects the design requirements as, for instance, the human anatomy. Moreover, through finite element analysis software and the knowledge of loads and conditions the prostheses are supposed to face in vivo, it is possible to simulate, analyze and predict the mechanical behavior of the prosthesis and its effects on the surrounding tissues. Moreover, the simulations are useful to eventually improve the design (as geometry, materials, features) before the actual production of the device. This article presents an extensive analysis on the use of finite element modeling for the design, testing and development of prosthesis and orthosis devices.
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Affiliation(s)
- Paola Serena Ginestra
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Elisabetta Ceretti
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Antonio Fiorentino
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
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Sun Z, Xu L. Computational fluid dynamics in coronary artery disease. Comput Med Imaging Graph 2014; 38:651-63. [PMID: 25262321 DOI: 10.1016/j.compmedimag.2014.09.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 08/22/2014] [Accepted: 09/03/2014] [Indexed: 01/01/2023]
Abstract
Computational fluid dynamics (CFD) is a widely used method in mechanical engineering to solve complex problems by analysing fluid flow, heat transfer, and associated phenomena by using computer simulations. In recent years, CFD has been increasingly used in biomedical research of coronary artery disease because of its high performance hardware and software. CFD techniques have been applied to study cardiovascular haemodynamics through simulation tools to predict the behaviour of circulatory blood flow in the human body. CFD simulation based on 3D luminal reconstructions can be used to analyse the local flow fields and flow profiling due to changes of coronary artery geometry, thus, identifying risk factors for development and progression of coronary artery disease. This review aims to provide an overview of the CFD applications in coronary artery disease, including biomechanics of atherosclerotic plaques, plaque progression and rupture; regional haemodynamics relative to plaque location and composition. A critical appraisal is given to a more recently developed application, fractional flow reserve based on CFD computation with regard to its diagnostic accuracy in the detection of haemodynamically significant coronary artery disease.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University, Perth, Western Australia 6845, Australia.
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
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28
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Arefin MS, Morsi YS. Fluid structure interaction (FSI) simulation of the left ventricle (LV) during the early filling wave (E-wave), diastasis and atrial contraction wave (A-wave). AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2014; 37:413-23. [PMID: 24570150 DOI: 10.1007/s13246-014-0250-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 01/30/2014] [Indexed: 12/01/2022]
Abstract
In this paper, the hemodynamic characteristics inside a physiologically correct three-dimensional LV model using fluid structure interaction scheme are examined under various heart beat conditions during early filling wave (E-wave), diastasis and atrial contraction wave (A-wave). The time dependent and incompressible viscous fluid, nonlinear viscous fluid and the stress tensor equations are coupled with the full Navier-Stoke's equations together with the Arbitrary Lagrangian-Eulerian and elasticity in the solid domain are used in the analysis. The results are discussed in terms of the variation in the intraventricular pressure, wall shear stress (WSS) and the fluid flow patterns inside the LV model. Moreover, changes in the magnitude of displacements on the LV are also observed during diastole period. The results obtained demonstrate that the magnitude of the intraventricle pressure is found higher in the basal region of the LV during the beginning of the E-wave and A-wave, whereas the Ip is found much higher in the apical region when the flow propagation is in peak E-wave, peak A-wave and diastasis. The magnitude of the pressure is found to be 5.4E2 Pa during the peak E-wave. Additionally, WSS elevates with the rise in the E-wave and A-wave but the magnitude decreases during the diastasis phase. During the peak E-wave, maximum WSS is found to be 5.7 Pa. Subsequent developments, merging and shifting of the vortices are observed throughout the filling wave. Formations of clockwise vortices are evident during the peak E-wave and at the onset of the A-wave, but counter clockwise vortices are found at the end of the diastasis and at the beginning of the A-wave. Moreover, the maximum magnitude of the structural displacement is seen in the ventricle apex with the value of 3.7E-5 m.
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Affiliation(s)
- Md S Arefin
- Biomechanical and Tissue Engineering Laboratory, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia,
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Sun Z. Coronary CT angiography: Beyond morphological stenosis analysis. World J Cardiol 2013; 5:444-452. [PMID: 24392188 PMCID: PMC3879698 DOI: 10.4330/wjc.v5.i12.444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 10/04/2013] [Accepted: 11/19/2013] [Indexed: 02/06/2023] Open
Abstract
Rapid technological developments in computed tomography (CT) imaging technique have made coronary CT angiography an attractive imaging tool in the detection of coronary artery disease. Despite visualization of excellent anatomical details of the coronary lumen changes, coronary CT angiography does not provide hemodynamic changes caused by presence of plaques. Computational fluid dynamics (CFD) is a widely used method in the mechanical engineering field to solve complex problems through analysing fluid flow, heat transfer and associated phenomena by using computer simulations. In recent years, CFD is increasingly used in biomedical research due to high performance hardware and software. CFD techniques have been used to study cardiovascular hemodynamics through simulation tools to assist in predicting the behaviour of circulatory blood flow inside the human body. Blood flow plays a key role in the localization and progression of coronary artery disease. CFD simulation based on 3D luminal reconstructions can be used to analyse the local flow fields and flow profiling due to changes of vascular geometry, thus, identifying risk factors for development of coronary artery disease. The purpose of this article is to provide an overview of the coronary CT-derived CFD applications in coronary artery disease.
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30
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Desai PM, Liew CV, Heng PW. Assessment of disintegration of rapidly disintegrating tablets by a visiometric liquid jet-mediated disintegration apparatus. Int J Pharm 2013; 442:65-73. [DOI: 10.1016/j.ijpharm.2012.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 08/20/2012] [Accepted: 09/01/2012] [Indexed: 11/16/2022]
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31
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Ha SJ, Kim W, Woo JS, Kim JB, Kim SJ, Kim WS, Kim MK, Cheng XW, Kim KS. Preventive effects of exenatide on endothelial dysfunction induced by ischemia-reperfusion injury via KATP channels. Arterioscler Thromb Vasc Biol 2011; 32:474-80. [PMID: 22155457 DOI: 10.1161/atvbaha.110.222653] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate whether exenatide administration can prevent impairment in endothelium-dependent vasodilatation induced by ischemia-reperfusion (IR) injury and whether this effect is mediated by K(ATP) channel opening. METHODS AND RESULTS In a double-blind, placebo-controlled, crossover design, 20 volunteers were randomly assigned to 2 groups: subcutaneous exenatide (10 μg) or placebo administration. At 30 minutes after the study drug administration, endothelium-dependent flow-mediated dilatation (FMD) of the radial artery was measured before and after IR (15 minutes of ischemia at the level of the brachial artery followed by 15 minutes of reperfusion) injury. Seven days later, both groups were crossed over and received the other treatment (ie, placebo or exenatide) and underwent the same protocol. Pre-IR radial artery diameter, FMD, and baseline radial artery diameter after IR injury were similar between 2 groups (P=no significant difference). After placebo administration, IR significantly blunted FMD (before IR: 12.0±6.23%; after IR: 4.6±3.57%, P=0.02). Exenatide prevented this impairment (FMD before IR: 15.0±7.14%; FMD after IR: 15.0±5.96%, P=no significant difference; P<0.001 compared with placebo). In a separate protocol, this protective effect was completely abolished by pretreatment with glibenclamide (glyburide, 5 mg), a blocker of K(ATP) channels (n=7; FMD before IR: 12.0±2.2%; after IR: 3.2±2.1%, P<0.001). CONCLUSIONS The present study demonstrates that subcutaneous exenatide protects IR-induced endothelial dysfunction through opening of K(ATP) channels in human IR injury model.
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Affiliation(s)
- Sang Jin Ha
- Division of Cardiovascular, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, #1 Hoegi-Dong, Dongdaemoon-Gu, Seoul 130-702, Korea
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