An idealized systemic-to-pulmonary shunt anatomy is parameterized and coupled to a closed loop, lumped parameter network (LPN) in a multidomain model of the Norwood surgical anatomy. The LPN approach is essential for obtaining information on global changes in cardiac output and oxygen delivery resulting from changes in local geometry and physiology. The LPN is fully coupled to a custom 3D finite element solver using a semi-implicit approach to model the heart and downstream circulation. This closed loop multidomain model is then integrated with a fully automated derivative-free optimization algorithm to obtain optimal shunt geometries with variable parameters of shunt diameter, anastomosis location, and angles. Three objective functions: (1) systemic; (2) coronary; and (3) combined systemic and coronary oxygen deliveries are maximized. Results show that a smaller shunt diameter with a distal shunt-brachiocephalic anastomosis is optimal for systemic oxygen delivery, whereas a more proximal anastomosis is optimal for coronary oxygen delivery and a shunt between these two anatomies is optimal for both systemic and coronary oxygen deliveries. Results are used to quantify the origin of blood flow going through the shunt and its relationship with shunt geometry. Results show that coronary artery flow is directly related to shunt position.
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e-mail: mesmaily@ucsd.edu
e-mail: francesco.migliavacca@polimi.it
e-mail: tyhsia@virginmedia.com
e-mail: amarsden@ucsd.edu
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Optimization of Shunt Placement for the Norwood Surgery Using Multi-Domain Modeling
Mahdi Esmaily Moghadam,
Mahdi Esmaily Moghadam
Ph.D. Student
Mechanical and Aerospace Engineering,
e-mail: mesmaily@ucsd.edu
University of California San Diego
, San Diego, CA 92093
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Francesco Migliavacca,
Francesco Migliavacca
Professor
Laboratory of Biological Structure Mechanics, Politecnico di Milano, 20133,
e-mail: francesco.migliavacca@polimi.it
Italy
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Irene E. Vignon-Clementel,
Irene E. Vignon-Clementel
Permanent Researcher
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Tain-Yen Hsia,
Tain-Yen Hsia
Cardiothoracic SurgeonCardiac Unit, Great Ormond Street Hospital for Children, WC1N 3JH,
e-mail: tyhsia@virginmedia.com
UK
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Alison L. Marsden,
Alison L. Marsden
Assistant Professor
Mechanical and Aerospace Engineering,
e-mail: amarsden@ucsd.edu
University of California San Diego
, San Diego, CA 92093
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Modeling of Congenital Hearts Alliance (MOCHA) Investigators
Modeling of Congenital Hearts Alliance (MOCHA) Investigators
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Mahdi Esmaily Moghadam
Ph.D. Student
Mechanical and Aerospace Engineering,
University of California San Diego
, San Diego, CA 92093e-mail: mesmaily@ucsd.edu
Francesco Migliavacca
Professor
Laboratory of Biological Structure Mechanics, Politecnico di Milano, 20133,
Italy
e-mail: francesco.migliavacca@polimi.it
Irene E. Vignon-Clementel
Permanent Researcher
Tain-Yen Hsia
Cardiothoracic SurgeonCardiac Unit, Great Ormond Street Hospital for Children, WC1N 3JH,
UK
e-mail: tyhsia@virginmedia.com
Alison L. Marsden
Assistant Professor
Mechanical and Aerospace Engineering,
University of California San Diego
, San Diego, CA 92093e-mail: amarsden@ucsd.edu
J Biomech Eng. May 2012, 134(5): 051002 (13 pages)
Published Online: May 25, 2012
Article history
Received:
August 26, 2011
Revised:
February 23, 2012
Posted:
May 14, 2012
Published:
May 25, 2012
Online:
May 25, 2012
Citation
Esmaily Moghadam, M., Migliavacca, F., Vignon-Clementel, I. E., Hsia, T., Marsden, A. L., and Modeling of Congenital Hearts Alliance (MOCHA) Investigators (May 25, 2012). "Optimization of Shunt Placement for the Norwood Surgery Using Multi-Domain Modeling." ASME. J Biomech Eng. May 2012; 134(5): 051002. https://doi.org/10.1115/1.4006814
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