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Title of Journal: Med Biol Eng Comput

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Abbravation: Medical & Biological Engineering & Computing

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Springer-Verlag

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DOI

10.1016/j.bbr.2009.06.026

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1741-0444

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Patientspecific surgical planning and hemodynamic

Authors: Kerem Pekkan Brian Whited Kirk Kanter Shiva Sharma Diane de Zelicourt Kartik Sundareswaran David Frakes Jarek Rossignac Ajit P Yoganathan
Publish Date: 2008/08/05
Volume: 46, Issue: 11, Pages: 1139-1152
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Abstract

The first version of an anatomy editing/surgical planning tool SURGEM targeting anatomical complexity and patientspecific computational fluid dynamics CFD analysis is presented Novel threedimensional 3D shape editing concepts and human–shape interaction technologies have been integrated to facilitate interactive surgical morphology alterations grid generation and CFD analysis In order to implement “manual hemodynamic optimization” at the surgery planning phase for patients with congenital heart defects these tools are applied to design and evaluate possible modifications of patientspecific anatomies In this context anatomies involve complex geometric topologies and tortuous 3D blood flow pathways with multiple inlets and outlets These tools make it possible to freely deform the lumen surface and to bend and position baffles through realtime direct manipulation of the 3D models with both hands thus eliminating the tedious and timeconsuming phase of entering the desired geometry using traditional computeraided design CAD systems The 3D models of the modified anatomies are seamlessly exported and meshed for patientspecific CFD analysis Freeformed anatomical modifications are quantified using an inhouse skeletization based crosssectional geometry analysis tool Hemodynamic performance of the systematically modified anatomies is compared with the original anatomy using CFD CFD results showed the relative importance of the various surgically created features such as pouch size vena cave to pulmonary artery PA flare and PA stenosis An interactive surgicalpatch size estimator is also introduced The combined design/analysis cycle time is used for comparing and optimizing surgical plans and improvements are tabulated The reduced cost of patientspecific shape design and analysis process made it possible to envision large clinical studies to assess the validity of predictive patientspecific CFD simulations In this paper model anatomical design studies are performed on a total of eight different complex patient specific anatomies Using SURGEM more than 30 new anatomical designs or candidate configurations are created and the corresponding user times presented CFD performances for eight of these candidate configurations are also presentedDrs Mark Fogel William Gaynor at the Children’s Hospital of Philadelphia Dr Pedro del Nido Boston Children’s Hospital Paul KrishbornEmory University and Dr W James Parks at Sibley Heart Center Egleston Children’s Hospital/Emory University Atlanta We also thank Hiroumi Kitajima and undergraduate student Gopinath Jayaprakash for providing most of the reconstructions used in this study Also Paymon Nourparvar and Vasu Yerneni assisted in the CFD simulations through Georgia Tech President’s Undergraduate Research Awards PURA Financial support National Heart Lung and Blood Institute Grant HL67622 and Seed Grant from the Graphics Visualization and Usability GVU Center at Georgia Tech

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