Multiscale modeling of a modified Blalock‐Taussig surgery in a patient‐specific tetralogy of Fallot,International Journal for Numerical Methods in Biomedical Engineering

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Multiscale modeling of a modified Blalock‐Taussig surgery in a patient‐specific tetralogy of Fallot
International Journal for Numerical Methods in Biomedical Engineering ( IF 2.2 ) Pub Date : 2021-01-13 , DOI: 10.1002/cnm.3436
Hamed Keramati _{1,

2} , Lex van Houts ₃ , Ching Kit Chen _{4,

5} , Frans van de Vosse ₃ , Masakazu Nakao ₆ , Sangho Kim _{1,

2} , Hwa Liang Leo _{1,

2}

Affiliation

Tetralogy of Fallot (TOF) is a congenital heart anomaly that causes a drastic reduction in the oxygen level. In this study, we coupled a lumped‐parameter model with a patient‐specific three‐dimensional (3D) model which included a modified Blalock‐Taussig (MBT) shunt. By forming a closed loop, we investigated the effects of certain parameters on the flow rates and the pressures at different locations of the developed network. A local sensitivity analysis on an initial zero‐dimensional (0D) closed‐loop model was conducted. The 0D lumped parameter (LP) model was then refined based on the results of the multiscale 0D‐3D model and the local sensitivity analysis was repeated for the refined 0D model. It was shown that the maximum pressure of the pulmonary bed had the highest sensitivity of 94% to the diameter of MBT shunt. We observed that the existence of the flow in the shunt during the diastole caused an elevated wall shear stress (WSS) in the pulmonary artery. In this work, we calculated the flow velocity and pressure field in a 3D patient‐specific aorta with an MBT shunt, and then we used the results to increase the accuracy of our LP model to simulate numerous 0D simulations in a significantly shorter time, which is potentially applicable for medical decision‐making.

中文翻译：

法洛四联症患者改良 Blalock-Taussig 手术的多尺度建模

法洛四联症 (TOF) 是一种先天性心脏异常，可导致氧含量急剧下降。在本研究中，我们将集总参数模型与患者特定的三维 (3D) 模型相结合，该模型包括改良的 Blalock-Taussig (MBT) 分流器。通过形成一个闭环，我们研究了某些参数对开发网络不同位置的流速和压力的影响。对初始零维 (0D) 闭环模型进行了局部敏感性分析。然后根据多尺度 0D-3D 模型的结果细化 0D 集总参数 (LP) 模型，并对细化后的 0D 模型重复局部灵敏度分析。结果表明，肺床最大压力对MBT分流管直径的敏感性最高，可达94%。我们观察到舒张期间分流器中存在的流动导致肺动脉壁剪切应力 (WSS) 升高。在这项工作中，我们计算了具有 MBT 分流器的 3D 患者特异性主动脉中的流速和压力场，然后我们使用结果来提高我们的 LP 模型的准确性，以在更短的时间内模拟大量 0D 模拟，从而可能适用于医疗决策。

更新日期：2021-01-13

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