title: A multiscale model for the study of cardiac biomechanics in single-ventricle surgeries: a clinical case.
abstract: Complex congenital heart disease characterized by the underdevelopment of one ventricular chamber (single ventricle (SV) circulation) is normally treated with a three-stage surgical repair. This study aims at developing a multiscale computational framework able to couple a patient-specific three-dimensional finite-element model of the SV to a patient-specific lumped parameter (LP) model of the whole circulation, in a closed-loop fashion. A sequential approach was carried out: (i) cardiocirculatory parameters were estimated by using a fully LP model; (ii) ventricular material parameters and unloaded geometry were identified by means of the stand-alone, three-dimensional model of the SV; and (iii) the three-dimensional model of SV was coupled to the LP model of the circulation, thus closing the loop and creating a multiscale model. Once the patient-specific multiscale model was set using pre-operative clinical data, the virtual surgery was performed, and the post-operative conditions were simulated. This approach allows the analysis of local information on ventricular function as well as global parameters of the cardiovascular system. This methodology is generally applicable to patients suffering from SV disease for surgical planning at different stages of treatment. As an example, a clinical case from stage 1 to stage 2 is considered here.
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Meoli
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Cutrì
authors.affiliation: Laboratory of Mechanics Iowa State University , Ames, IA 50011 , USA.
authors.forename: Adarsh
authors.initials: A
authors.lastname: Krishnamurthy
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Dubini
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Migliavacca
authors.affiliation: Department of Cardiothoracic Surgery , Great Ormond Street Hospital for Children, NHS Foundation Trust , London WC1N 3JH , UK.
authors.forename: Tain-Yen
authors.initials: TY
authors.lastname: Hsia
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pennati
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Andrew
authors.initials: A
authors.lastname: Taylor
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giardini
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Sachin
authors.initials: S
authors.lastname: Khambadkone
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Schievano
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Marc
authors.initials: M
authors.lastname: de Leval
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: T-Y
authors.initials: TY
authors.lastname: Hsia
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Edward
authors.initials: E
authors.lastname: Bove
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Adam
authors.initials: A
authors.lastname: Dorfman
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: G Hamilton
authors.initials: GH
authors.lastname: Baker
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Anthony
authors.initials: A
authors.lastname: Hlavacek
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Migliavacca
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pennati
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Dubini
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Alison
authors.initials: A
authors.lastname: Marsden
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Feinstein
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Vignon-Clementel
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: Richard
authors.initials: R
authors.lastname: Figliola
authors.affiliation: Laboratory of Biological Structure Mechanics, Chemistry, Materials and Chemical Engineering Department 'Giulio Natta', Politecnico di Milano, Milan , Italy.
authors.forename: John
authors.initials: J
authors.lastname: McGregor
keywords: finite-element method; lumped parameter model; multiscale coupling; single ventricle heart; virtual surgery
references.citation: J Comput Phys. 2013 Jul 1;244:4-21
references.pmid: 23729839
references.citation: Am J Physiol. 1981 Sep;241(3):H389-400
references.pmid: 7282948
references.citation: Am J Physiol Heart Circ Physiol. 2001 May;280(5):H2076-86
references.pmid: 11299209
references.citation: Circ Res. 1969 Mar;24(3):339-47
references.pmid: 5766515
references.citation: J Biomech. 1994 Apr;27(4):455-67
references.pmid: 8188726
references.citation: Prog Biophys Mol Biol. 2014 Sep;116(1):3-10
references.pmid: 25157924
references.citation: Ann Thorac Surg. 2012 Nov;94(5):1562-9
references.pmid: 22858280
references.citation: Comput Methods Biomech Biomed Engin. 2010 Oct;13(5):625-40
references.pmid: 20140798
references.citation: Med Image Anal. 2009 Apr;13(2):362-9
references.pmid: 18675578
references.citation: J Thorac Cardiovasc Surg. 2006 Apr;131(4):785-91
references.pmid: 16580435
references.citation: Ann Biomed Eng. 2009 Jan;37(1):50-63
references.pmid: 18987974
references.citation: Nat Rev Cardiol. 2010 Sep;7(9):520-7
references.pmid: 20585329
references.citation: Neth Heart J. 2011 Sep;19(9):369-72
references.pmid: 21678061
references.citation: J Biomech. 2013 Jan 18;46(2):423-9
references.pmid: 23174419
references.citation: J Biomech. 1987;20(6):577-89
references.pmid: 3611134
references.citation: Am J Physiol Heart Circ Physiol. 2002 Dec;283(6):H2650-9
references.pmid: 12427603
references.citation: Philos Trans A Math Phys Eng Sci. 2011 Nov 13;369(1954):4316-30
references.pmid: 21969678
references.citation: Prog Biophys Mol Biol. 2011 Oct;107(1):147-55
references.pmid: 21763714
references.citation: Am J Physiol Heart Circ Physiol. 2006 Jul;291(1):H403-12
references.pmid: 16428349
references.citation: Biorheology. 2002;39(3-4):359-64
references.pmid: 12122253
references.citation: Med Biol Eng Comput. 2013 Nov;51(11):1261-70
references.pmid: 23340962
references.citation: Comput Methods Biomech Biomed Engin. 2014;17(14):1572-89
references.pmid: 23343002
references.citation: J Thorac Cardiovasc Surg. 2009 Feb;137(2):394-403.e2
references.pmid: 19185159
references.citation: Philos Trans A Math Phys Eng Sci. 2009 Sep 13;367(1902):3445-75
references.pmid: 19657007
references.citation: Am J Physiol. 1991 Apr;260(4 Pt 2):H1365-78
references.pmid: 2012234
references.citation: J Am Coll Cardiol. 2012 Jan 3;59(1 Suppl):S1-42
references.pmid: 22192720
references.citation: Med Biol Eng Comput. 2008 Nov;46(11):1139-52
references.pmid: 18679735
references.citation: Ann Biomed Eng. 2009 Nov;37(11):2234-55
references.pmid: 19718527