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首页> 外文会议>International Conference on Medical Image Computing and Computer-Assisted Intervention >Virtual Cardiac Surgical Planning Through Hemodynamics Simulation and Design Optimization of Fontan Grafts
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Virtual Cardiac Surgical Planning Through Hemodynamics Simulation and Design Optimization of Fontan Grafts

机译：虚拟心脏手术规划通过血流动力学仿真与Fontan移植物的设计优化

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For complex congenital heart disease (CHD) involving a single functioning ventricle, the Fontan operation is performed which results in a circulation where deoxygenated venous blood passively flows into the pulmonary arteries without a ventricular pump. However, conventional Fontan graft designs may result in suboptimal cardiovascular hemodynamics leading to post-surgical complications. Patient-specific designs are thus promising in the Fontan operation. This paper reports the virtual simulation and designs of patient-specific Fontan grafts with the aid of computational fluid dynamics (CFD). CFD parameters including meshing, wall layers, and solver choices were studied to bolster accuracy while minimizing computational time. CFD simulations of original Fontan design were performed to evaluate three hemodynamic parameters: indexed power loss (iPL), hepatic flow distribution (HFD), and percentage of the non-physiological wall shear stress (%WSS, a novel surrogate marker for clot risk). New designs were then created to target these parameters with iterative optimization technique. This overall approach was utilized to redesign the Fontan grafts of patients (n = 2). The re-designed Fontan grafts showed significant improvements in all three hemodynamic parameters when compared to the original designs. Our unique integration of surgical design and flow simulation has the potential to enable cardiac surgeons to effectively simulate patient specific designs for the Fontan operation, potentially improving the surgical outcomes of patients with complex CHD.
机译：对于涉及单一功能性心室的复杂先天性心脏病（CHD），进行Fontan操作，这导致循环，其中脱氧静脉血液被动地流入肺动脉而没有心室泵。然而，传统的Fontan接枝设计可能导致次优心血管血流动力学导致手术后并发症。因此，特定于患者的设计在Fontan操作中具有很有希望。本文借助计算流体动力学（CFD）报道了患者特定于患者特定的Fontan移植物的虚拟仿真和设计。在最小化计算时间的同时，研究了包括啮合，墙层和求解器选择的CFD参数，包括升高的准确性。进行CFD模拟原始的Fontan设计，以评估三种血液动力学参数：索引功率损失（IPL），肝流量分布（HFD）和非生理墙剪应力的百分比（％WSS，一种用于凝块风险的新型替代标记） 。然后创建新设计以利用迭代优化技术来定位这些参数。这种整体方法被利用来重新设计患者的Fontan移植物（n = 2）。与原始设计相比，重新设计的Fontan移植物显示出所有三个血液动力学参数的显着改进。我们独特的外科设计和流动模拟集成有可能使心脏外科医生能够有效地模拟Fontan操作的患者特定设计，可能改善复杂CHD患者的外科患者。

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