PhD Scientific Days 2018

Budapest, April 19–20, 2018

Computer assisted decision making in cardiac surgery: from 3D preoperative planning to computational fluid dynamics in the design of surgical procedures

Barabás, Imre

Imre J. Barabás, Semmelweis University, Division of Cardiac Surgery, Budapest Hungary
Kálmán Benke, Semmelweis University, Division of Cardiac Surgery, Budapest Hungary
Andrea Kőszegi, Semmelweis University, Division of Cardiac Surgery, Budapest Hungary
Ferenc Horkay, Semmelweis University, Division of Cardiac Surgery, Budapest Hungary
Zoltán Szabolcs, Semmelweis University, Division of Cardiac Surgery, Budapest Hungary
Béla Merkely, Semmelweis University, Department of Cardiology, Budapest Hungary
István Hartyánszky, Semmelweis University, Division of Cardiac Surgery, Budapest Hungary

Language of the presentation

English

Text of the abstract

Introduction: Although the surgical specialties utilized static model but by the evolution of dynamical planning method and practical usage of computer simulations created the possibility of introduction of dynamical parameters in cardiac surgery.
Aims: Our aim was the amelioration and application of 3D models in cardiac surgical practice wherewith the prediction of fluid dynamical variables and remaining ventricle shape, volume and function in surgical ventricle restoration cases.
Method: Using own developed script, the raw Dicom files were imported, the dilated left ventricle was modeled and fluid dynamical parameters simulated, such as flow kinematic and profile analysis, turbulence calculation and myocardial response to shear stress. Then step-by-step simulation of the surgical ventricle restoration procedure was accomplished and the calculated variables were imbedded in silico model of the left ventricle reconstruction. The extension and length of resection lines were modified based on the previous computer simulation. Optimal resection of the myocardium was applied during the operation, considering the all feasibility.
Results: The sphericity and conicity indexes were improved significantly in postoperative period (0,42vs. 0,67 és 0,36vs. 0,72, p‹0,05, Student t-test). The occurred shear stress at endocardium decreased 83% due to the normalization of flow kinematic pattern of the ventricle in postoperative period (54±12vs. 32±9 p‹0,02, Student t-test). The postoperative turbulent flow pattern - based on Reynolds number - significantly decreased, according to our computational method (2712vs. 1823, p‹0,0001, Student t-test).
Conclusion: With our method, the standardization of the surgical ventricle reconstruction was achievable and the surgical steps were predictable. Therefore, a new decision making support system was established in cardiac surgery for high risk patients. Consequently, a personalized surgical technique was offered our patients, improving their life expectancy and quality of life.

Data of the presenter

Doctoral School: Basic and Translational Medicine
Program: Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Supervisor: István Hartyánszky
E-mail address: barabasji@gmail.com