Olivia K Ginty1, John T Moore2, Mehdi Eskandari3, Patrick Carnahan2, Andras Lasso4, Matthew A Jolley5, Mark Monaghan3, Terry M Peters2,6. 1. Robarts Research Institute, Western University, London, N6A5B7, Canada. oginty@uwo.ca. 2. Robarts Research Institute, Western University, London, N6A5B7, Canada. 3. King's College Hospital, Denmark Hill, London, SE59RS, UK. 4. Laboratory for Percutaneous Surgery, Queen's University, Kingston, K7L3N6, Canada. 5. Department of Anesthesiology and Critical Care Medicine/Division of Pediatric Cardiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, 19104, USA. 6. Department of Medical Biophysics, Medical Imaging, School of Biomedical Engineering, Western University, London, N6A3K7, Canada.
Abstract
PURPOSE: Transcatheter, beating heart repair techniques for mitral valve regurgitation is a very active area of development. However, it is difficult to both simulate and predict the clinical outcomes of mitral repairs, owing to the complexity of mitral valve geometry and the influence of hemodynamics. We aim to produce a workflow for manufacturing dynamic patient-specific models to simulate the mitral valve for transcatheter repair applications. METHODS: In this paper, we present technology and associated workflow, for using transesophageal echocardiography to generate dynamic physical replicas of patient valves. We validate our workflow using six patient datasets representing patients with unique or particularly challenging pathologies as selected by a cardiologist. The dynamic component of the models and their resultant potential as procedure planning tools is due to a dynamic pulse duplicator that permits the evaluation of the valve models experiencing realistic hemodynamics. RESULTS: Early results indicate the workflow has excellent anatomical accuracy and the ability to replicate regurgitation pathologies, as shown by colour Doppler ultrasound and anatomical measurements comparing patients and models. Analysis of all measurements successfully resulted in t critical two-tail > t stat and p values > 0.05, thus demonstrating no statistical difference between the patients and models, owing to high fidelity morphological replication. CONCLUSIONS: Due to the combination of a dynamic environment and patient-specific modelling, this workflow demonstrates a promising technology for simulating the complete morphology of mitral valves undergoing transcatheter repairs.
PURPOSE: Transcatheter, beating heart repair techniques for mitral valve regurgitation is a very active area of development. However, it is difficult to both simulate and predict the clinical outcomes of mitral repairs, owing to the complexity of mitral valve geometry and the influence of hemodynamics. We aim to produce a workflow for manufacturing dynamic patient-specific models to simulate the mitral valve for transcatheter repair applications. METHODS: In this paper, we present technology and associated workflow, for using transesophageal echocardiography to generate dynamic physical replicas of patient valves. We validate our workflow using six patient datasets representing patients with unique or particularly challenging pathologies as selected by a cardiologist. The dynamic component of the models and their resultant potential as procedure planning tools is due to a dynamic pulse duplicator that permits the evaluation of the valve models experiencing realistic hemodynamics. RESULTS: Early results indicate the workflow has excellent anatomical accuracy and the ability to replicate regurgitation pathologies, as shown by colour Doppler ultrasound and anatomical measurements comparing patients and models. Analysis of all measurements successfully resulted in t critical two-tail > t stat and p values > 0.05, thus demonstrating no statistical difference between the patients and models, owing to high fidelity morphological replication. CONCLUSIONS: Due to the combination of a dynamic environment and patient-specific modelling, this workflow demonstrates a promising technology for simulating the complete morphology of mitral valves undergoing transcatheter repairs.
Authors: Hannah H Nam; Christian Herz; Andras Lasso; Alana Cianciulli; Maura Flynn; Jing Huang; Zi Wang; Beatriz Paniagua; Jared Vicory; Saleha Kabir; John Simpson; David Harrild; Gerald Marx; Meryl S Cohen; Andrew C Glatz; Matthew A Jolley Journal: J Am Soc Echocardiogr Date: 2022-05-07 Impact factor: 7.722
Authors: Andras Lasso; Christian Herz; Hannah Nam; Alana Cianciulli; Steve Pieper; Simon Drouin; Csaba Pinter; Samuelle St-Onge; Chad Vigil; Stephen Ching; Kyle Sunderland; Gabor Fichtinger; Ron Kikinis; Matthew A Jolley Journal: Front Cardiovasc Med Date: 2022-09-06
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