Application of an adaptive control grid interpolation technique to morphological vascular reconstruction

Frakes, David; Conrad, C.P.; Healy, Timothy M.; Monaco, Joseph W.; Fogel, Mark A.; Sharma, Sanjeevan; Smith, M.J.T.; Yoganathan, Ajit P.

doi:10.1109/tbme.2002.807651

Cited by 63 publications

(52 citation statements)

References 34 publications

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“…21 The anatomic models are obtained from patient MRI data by enhancing the out-of-plane image resolution with an adaptive control grid interpolation technique 26 and then segmenting the vessels of interest. The patient-specific TCPC fluid dynamic analysis methodology, which uses in vitro computational and experimental models, is described elsewhere.…”

Section: Reconstruction Methods and Geometrymentioning

confidence: 99%

Total Cavopulmonary Connection Flow With Functional Left Pulmonary Artery Stenosis

et al. 2005

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Background-In our multicenter study of the total cavopulmonary connection (TCPC), a cohort of patients with long-segment left pulmonary artery (LPA) stenosis was observed (35%). The clinically recognized detrimental effects of LPA stenosis motivated a computational fluid dynamic simulation study within 3-dimensional patient-specific and idealized TCPC pathways. The goal of this study was to quantify and evaluate the hemodynamic impact of LPA stenosis and to judge interventional strategies aimed at treating it. Methods and Results-Simulations were conducted at equal vascular lung resistance, modeling both discrete stenosis (DS) and diffuse long-segment hypoplasia with varying degrees of obstruction (0% to 80%). Models having fenestrations of 2 to 6 mm and atrium pressures of 4 to 14 mm Hg were explored. A patient-specific, extracardiac TCPC with 85% DS was studied in its original configuration and after virtual surgery that dilated the LPA to 0% stenosis in the computer medium. Performance indices improved exponentially (R 2 Ͼ0.99) with decreasing obstruction. Diffuse long-segment hypoplasia was Ϸ50% more severe with regard to lung perfusion and cardiac energy loss than DS. Virtual angioplasty performed on the 3-dimensional Fontan anatomy exhibiting an 85% DS stenosis produced a 61% increase in left lung perfusion and a 50% decrease in cardiac energy dissipation. After 4-mm fenestration, TCPC baffle pressure dropped by Ϸ10% and left lung perfusion decreased by Ϸ8% compared with the 80% DS case. Conclusions-DS Ͻ60% and diffuse long-segment hypoplasia Ͻ40% could be considered tolerable because both resulted in only a 12% decrease in left lung perfusion. In contrast to angioplasty, a fenestration (right-to-left shunt) reduced TCPC pressure at the cost of decreased left and right lung perfusion. These results suggest that pre-Fontan computational fluid dynamic simulation may be valuable for determining both the hemodynamic significance of LPA stenosis and the potential benefits of intervention. (Circulation. 2005;112:3264-3271.)

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Section: Reconstruction Methods and Geometrymentioning

confidence: 99%

Total Cavopulmonary Connection Flow With Functional Left Pulmonary Artery Stenosis

et al. 2005

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“…Three-dimensional anatomic and flow reconstructions of the TCPC were generated using techniques previously developed and validated (9). From this database, 16 patient-specific geometries (6 intra-atrial, 9 extra-cardiac, and 1 IVC-main pulmonary artery) were selected for computational fluid dynamic (CFD) simulations.…”

Section: Patient Datamentioning

confidence: 99%

The total cavopulmonary connection resistance: a significant impact on single ventricle hemodynamics at rest and exercise

Sundareswaran¹,

Pekkan²,

Dasi³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

110

140

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AP. The total cavopulmonary connection resistance: a significant impact on single ventricle hemodynamics at rest and exercise. Am J Physiol Heart Circ Physiol 295: H2427-H2435, 2008. First published October 17, 2008 doi:10.1152/ajpheart.00628.2008Little is known about the impact of the total cavopulmonary connection (TCPC) on resting and exercise hemodynamics in a single ventricle (SV) circulation. The aim of this study was to elucidate this mechanism using a lumped parameter model of the SV circulation. Pulmonary vascular resistance (1.96 Ϯ 0.80 WU) and systemic vascular resistances (18.4 Ϯ 7.2 WU) were obtained from catheterization data on 40 patients with a TCPC. TCPC resistances (0.39 Ϯ 0.26 WU) were established using computational fluid dynamic simulations conducted on anatomically accurate three-dimensional models reconstructed from MRI (n ϭ 16). These parameters were used in a lumped parameter model of the SV circulation to investigate the impact of TCPC resistance on SV hemodynamics under resting and exercise conditions. A biventricular model was used for comparison. For a biventricular circulation, the cardiac output (CO) dependence on TCPC resistance was negligible (sensitivity ϭ Ϫ0.064 l ⅐ min Ϫ1 ⅐ WU Ϫ1 ) but not for the SV circulation (sensitivity ϭ Ϫ0.88 l ⅐ min Ϫ1 ⅐ WU Ϫ1 ). The capacity to increase CO with heart rate was also severely reduced for the SV. At a simulated heart rate of 150 beats/min, the SV patient with the highest resistance (1.08 WU) had a significantly lower increase in CO (20.5%) compared with the SV patient with the lowest resistance (50%) and normal circulation (119%). This was due to the increased afterload (ϩ35%) and decreased preload (Ϫ12%) associated with the SV circulation. In conclusion, TCPC resistance has a significant impact on resting hemodynamics and the exercise capacity of patients with a SV physiology. mathematical modeling; cardiac function; congenital heart defects; magnetic resonance imaging THE FONTAN PROCEDURE, composing of connecting the systemic and pulmonary circulation in series via the total cavopulmonary connection (TCPC), is the primary palliative option for physiological correction of single ventricle (SV) congenital heart diseases (2, 3). Although postoperative survival is excellent, with some centers having a mortality of Ͻ1%, studies have repeatedly demonstrated poor functional outcome in survivors (15-18), including significantly reduced exercise capacity, diminished cardiac output (CO), and risks of heart failure (5, 10 -12, 16, 32, 35, 36, 40). Among all the parameters that come into play, decreased cardiac function in these patients seems to be one of the key players responsible for the poor functional outcome (26, 35). However, the impact of the surgically altered TCPC on cardiac function or functional outcome has not been well understood.Poor cardiac function in SV patients can be associated with many factors. For example, Fogel et al. (8) demonstrated that the presence of the lateral tunnel baffle restricted the motion of the atrioventric...

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“…Out-of-plane image resolution is enhanced with an adaptive control grid interpolation technique to produce isotropic voxels. 18 Each TCPC is isolated within the enhanced MRI data using a shape-element segmentation technique. Intensity thresholding and edge detection methods are used to create a scaffold around the TCPC, within which the vascular area of interest is defined by the motion of a shape element.…”

Section: Anatomic and Flow Datamentioning

confidence: 99%

Nonlinear Power Loss During Exercise in Single-Ventricle Patients After the Fontan

et al. 2007

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Background-We previously demonstrated that power loss (PL) through the total cavopulmonary connection (TCPC) in single-ventricle patients undergoing Fontan can be calculated by computational fluid dynamic analysis using 3-dimensional MRI anatomic reconstructions. PL through the TCPC may play a role in single-ventricle physiology and is a function of cardiac output. We hypothesized that PL through the TCPC increases significantly under exercise flow conditions. Methods and Results-MRI data of 10 patients with a TCPC were analyzed to obtain 3-dimensional geometry and flow rates through the superior vena cava, inferior vena cava, left pulmonary artery, and right pulmonary artery. Steady computational fluid dynamic simulations were performed at baseline conditions using MRI-derived flows. Simulated exercise conditions of twice (2ϫ) and three times (3ϫ) baseline flow were performed by increasing inferior vena cava flow. PL, head loss, and effective resistance through the TCPC were calculated for each condition. Each condition was repeated at left pulmonary artery/right pulmonary artery ratios of 30/70 and 70/30 to determine the effects of pulmonary flow splits on exercise PL. For each patient, PL increases dramatically in a nonlinear fashion with increasing cardiac output, even when normalized to calculate head loss or resistance. Flow splits had a significant effect on PL at exercise, with most geometries favoring right pulmonary artery flow. Conclusions-The relationship between cardiac output and PL is nonlinear and highly dependent on TCPC geometry and pulmonary flow splits. This study demonstrates the importance of studying the TCPC under exercise conditions, because baseline conditions may not adequately characterize TCPC efficiency.

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Application of an adaptive control grid interpolation technique to morphological vascular reconstruction

Cited by 63 publications

References 34 publications

Total Cavopulmonary Connection Flow With Functional Left Pulmonary Artery Stenosis

Total Cavopulmonary Connection Flow With Functional Left Pulmonary Artery Stenosis

The total cavopulmonary connection resistance: a significant impact on single ventricle hemodynamics at rest and exercise

Nonlinear Power Loss During Exercise in Single-Ventricle Patients After the Fontan

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