Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome
First stage palliation of hypoplastic left heart syndrome (HLHS), i.e. the Norwood operation, results in a complex physiological arrangement, involving different shunting options (modified Blalock-Taussig, RV-PA conduit, central shunt from the ascending aorta) and enlargement of the hypoplastic asce...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2013-10-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fped.2013.00031/full |
| _version_ | 1818844670017404928 |
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| author | Giovanni eBiglino Giovanni eBiglino Alessandro eGiardini Tain-Yen eHsia Richard eFigliola Andrew M Taylor Andrew M Taylor Silvia eSchievano Silvia eSchievano |
| author_facet | Giovanni eBiglino Giovanni eBiglino Alessandro eGiardini Tain-Yen eHsia Richard eFigliola Andrew M Taylor Andrew M Taylor Silvia eSchievano Silvia eSchievano |
| author_sort | Giovanni eBiglino |
| collection | DOAJ |
| description | First stage palliation of hypoplastic left heart syndrome (HLHS), i.e. the Norwood operation, results in a complex physiological arrangement, involving different shunting options (modified Blalock-Taussig, RV-PA conduit, central shunt from the ascending aorta) and enlargement of the hypoplastic ascending aorta. Engineering techniques, both computational and experimental, can aid in the understanding of the Norwood physiology and their correct implementation can potentially lead to refinement of the decision-making process, by means of patient-specific simulations. This paper presents some of the available tools that can corroborate clinical evidence by providing detailed insight into the fluid dynamics of the Norwood circulation as well as alternative surgical scenarios (i.e. virtual surgery). Patient-specific anatomies can be manufactured by means of rapid prototyping and such models can be inserted in experimental setups (mock circulatory loops) that can provide a valuable source of validation data as well as hydrodynamic information. Experimental setups can also be compatible with visualisation techniques, like particle image velocimetry (PIV) and cardiovascular magnetic resonance (CMR), further adding to the knowledge of the local fluid dynamics. Multi-scale computational models include detailed 3D anatomical information coupled to a lumped parameter network representing the remainder of the circulation. These models output both overall hemodynamic parameters while also enabling to investigate the local fluid dynamics of the aortic arch or the shunt. As an alternative, pure lumped parameter models can also be employed to model Stage 1 palliation, taking advantage of a much lower computational cost, albeit missing the 3D anatomical component. Finally, analytical techniques, such as wave intensity analysis, can be employed to study the Norwood physiology, providing a mechanistic perspective on the ventriculo-arterial coupling for this specific surgical scenario. |
| first_indexed | 2024-12-19T05:17:27Z |
| format | Article |
| id | doaj.art-ca076e2d4ae34aa6be28782c513f2788 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-19T05:17:27Z |
| publishDate | 2013-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-ca076e2d4ae34aa6be28782c513f27882022-12-21T20:34:37ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602013-10-01110.3389/fped.2013.0003164067Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndromeGiovanni eBiglino0Giovanni eBiglino1Alessandro eGiardini2Tain-Yen eHsia3Richard eFigliola4Andrew M Taylor5Andrew M Taylor6Silvia eSchievano7Silvia eSchievano8University College London (Institute of Cardiovascular Science)Great Ormond Street Hospital for Children NHS Foundation TrustGreat Ormond Street Hospital for Children NHS Foundation TrustGreat Ormond Street Hospital for Children NHS Foundation TrustClemson UniversityUniversity College London (Institute of Cardiovascular Science)Great Ormond Street Hospital for Children NHS Foundation TrustUniversity College London (Institute of Cardiovascular Science)Great Ormond Street Hospital for Children NHS Foundation TrustFirst stage palliation of hypoplastic left heart syndrome (HLHS), i.e. the Norwood operation, results in a complex physiological arrangement, involving different shunting options (modified Blalock-Taussig, RV-PA conduit, central shunt from the ascending aorta) and enlargement of the hypoplastic ascending aorta. Engineering techniques, both computational and experimental, can aid in the understanding of the Norwood physiology and their correct implementation can potentially lead to refinement of the decision-making process, by means of patient-specific simulations. This paper presents some of the available tools that can corroborate clinical evidence by providing detailed insight into the fluid dynamics of the Norwood circulation as well as alternative surgical scenarios (i.e. virtual surgery). Patient-specific anatomies can be manufactured by means of rapid prototyping and such models can be inserted in experimental setups (mock circulatory loops) that can provide a valuable source of validation data as well as hydrodynamic information. Experimental setups can also be compatible with visualisation techniques, like particle image velocimetry (PIV) and cardiovascular magnetic resonance (CMR), further adding to the knowledge of the local fluid dynamics. Multi-scale computational models include detailed 3D anatomical information coupled to a lumped parameter network representing the remainder of the circulation. These models output both overall hemodynamic parameters while also enabling to investigate the local fluid dynamics of the aortic arch or the shunt. As an alternative, pure lumped parameter models can also be employed to model Stage 1 palliation, taking advantage of a much lower computational cost, albeit missing the 3D anatomical component. Finally, analytical techniques, such as wave intensity analysis, can be employed to study the Norwood physiology, providing a mechanistic perspective on the ventriculo-arterial coupling for this specific surgical scenario.http://journal.frontiersin.org/Journal/10.3389/fped.2013.00031/fullComputational modellingshuntingNorwood proceduresingle ventricleexperimental modelling |
| spellingShingle | Giovanni eBiglino Giovanni eBiglino Alessandro eGiardini Tain-Yen eHsia Richard eFigliola Andrew M Taylor Andrew M Taylor Silvia eSchievano Silvia eSchievano Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome Frontiers in Pediatrics Computational modelling shunting Norwood procedure single ventricle experimental modelling |
| title | Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome |
| title_full | Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome |
| title_fullStr | Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome |
| title_full_unstemmed | Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome |
| title_short | Modelling single ventricle physiology: Review of engineering tools to study first stage palliation of hypoplastic left heart syndrome |
| title_sort | modelling single ventricle physiology review of engineering tools to study first stage palliation of hypoplastic left heart syndrome |
| topic | Computational modelling shunting Norwood procedure single ventricle experimental modelling |
| url | http://journal.frontiersin.org/Journal/10.3389/fped.2013.00031/full |
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