Simulation as a preoperative planning approach in advanced heart failure patients. A retrospective clinical analysis

Massimo Capoccia, Silvia Marconi, Sanjeet Avtaar Singh, Domenico M. Pisanelli, Claudio De Lazzari

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Abstract

Background: Modelling and simulation may become clinically applicable tools for detailed evaluation of the cardiovascular system and clinical decision-making to guide therapeutic intervention. Models based on pressure-volume relationship and zero-dimensional representation of the cardiovascular system may be a suitable choice given their simplicity and versatility. This approach has great potential for application in heart failure where the impact of left ventricular assist devices has played a significant role as a bridge to transplant and more recently as a long-term solution for non eligible candidates. Results: We sought to investigate the value of simulation in the context of three heart failure patients with a view to predict or guide further management. CARDIOSIM© was the software used for this purpose. The study was based on retrospective analysis of haemodynamic data previously discussed at a multidisciplinary meeting. The outcome of the simulations addressed the value of a more quantitative approach in the clinical decision process. Conclusions: Although previous experience, co-morbidities and the risk of potentially fatal complications play a role in clinical decision-making, patient-specific modelling may become a daily approach for selection and optimisation of device-based treatment for heart failure patients. Willingness to adopt this integrated approach may be the key to further progress.

Original languageEnglish
Article number52
JournalBioMedical Engineering Online
Volume17
Issue number1
DOIs
Publication statusPublished - 2 May 2018

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Keywords

  • CARDIOSIM
  • heart failure
  • modelling
  • simulation
  • ventricular assist device

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