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Semi-Automatic Planning and Three-Dimensional Electrospinning of Patient-Specific Grafts for Fontan Surgery.

Authors :
Liu, Xiaolong
Kim, Byeol
Loke, Yue-Hin
Mass, Paige
Olivieri, Laura
Hibino, Narutoshi
Fuge, Mark
Krieger, Axel
Source :
IEEE Transactions on Biomedical Engineering. Jan2022, Vol. 69 Issue 1, p186-198. 13p.
Publication Year :
2022

Abstract

This paper proposes a semi-automatic Fontan surgery planning method for designing and manufacturing hemodynamically optimized patient-specific grafts. Fontan surgery is a palliative procedure for patients with a single ventricle heart defect by creating a new path using a vascular graft for the deoxygenated blood to be directed to the lungs, bypassing the heart. However, designing patient-specific grafts with optimized hemodynamic performance is a complex task due to the variety of patient-specific anatomies, confined surgical planning space, and the requirement of simultaneously considering multiple design criteria for vascular graft optimization. To address these challenges, we used parameterized Fontan pathways to explore patient-specific vascular graft design spaces and search for optimal solutions by formulating a nonlinear constrained optimization problem, which minimizes indexed power loss (iPL) of the Fontan model by constraining hepatic flow distribution (HFD), percentage of abnormal wall shear stress (%WSS) and geometric interference between Fontan pathways and the heart models (InDep) within clinically acceptable thresholds. Gaussian process regression was employed to build surrogate models of the hemodynamic parameters as well as InDep and $\text{N}_\text{v}$ (conduit model smoothness indicator) for optimization by pattern search. We tested the proposed method on two patient-specific models (n=2). The results showed the automatically optimized (AutoOpt) Fontan models hemodynamically outperformed or at least are comparable to manually optimized Fontan models with significantly reduced surgical planning time (15 hours versus over 2 weeks). We also demonstrated feasibility of manufacturing the AutoOpt Fontan conduits by using electrospun nanofibers. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00189294
Volume :
69
Issue :
1
Database :
Academic Search Index
Journal :
IEEE Transactions on Biomedical Engineering
Publication Type :
Academic Journal
Accession number :
154310649
Full Text :
https://doi.org/10.1109/TBME.2021.3091113