Content area
Full text
http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = Annals of Biomedical Engineering, Vol. 44, No. 1, January 2016 ( 2015) pp. 174186 DOI: 10.1007/s10439-015-1381-9
http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = http://crossmark.crossref.org/dialog/?doi=10.1007/s10439-015-1381-9&domain=pdf
Web End = Computational Biomechanics for Patient-Specic Applications
Patient-Specic Surgical Planning, Where Do We Stand? The Example of the Fontan Procedure
DIANE A. DE ZLICOURT1 and VARTAN KURTCUOGLU1,2,3
1The Interface Group, Institute of Physiology, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland; 2Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; and 3National Center of Competence Kidney.CH, Zurich, Switzerland
(Received 1 April 2015; accepted 2 July 2015; published online 17 July 2015)
Associate Editor Karol Miller oversaw the review of this article.
AbstractThe Fontan surgery for single ventricle heart defects is a typical example of a clinical intervention in which patient-specic computational modeling can improve patient outcome: with the functional heterogeneity of the presenting patients, which precludes generic solutions, and the clear inuence of the surgically-created Fontan connection on hemodynamics, it is acknowledged that individualized computational optimization of the post-operative hemodynamics can be of clinical value. A large body of literature has thus emerged seeking to provide clinically relevant answers and innovative solutions, with an increasing emphasis on patient-specic approaches. In this review we discuss the benets and challenges of patient-specic simulations for the Fontan surgery, reviewing state of the art solutions and avenues for future development. We rst discuss the clinical impact of patient-specic simulations, notably how they have contributed to our understanding of the link between Fontan hemodynamics and patient outcome. This is followed by a survey of methodologies for capturing patient-specic hemo-dynamics, with an emphasis on the challenges of dening patient-specic boundary conditions and their extension for prediction of post-operative outcome. We conclude with insights into potential future directions, noting that one of the most pressing issues might be the validation of the predictive capabilities of the developed framework.
KeywordsSingle ventricle heart defects, Total cavopulmonary connection (TCPC), Computational uid dynamics (CFD), Numerical simulations, Boundary conditions, Multi-scale, Review.
INTRODUCTION
Simulation-based optimization is a concept that is progressively making its way from engineering and industrial applications to the biomedical...