Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.

<h4>Background</h4>Right (R) or left (L) ventricular outflow tract (VOT) obstruction can be either a dynamic phenomenon or a congenital anatomic lesion, which requires a prompt and optimal timing of treatment to avoid a pathological ventricular remodelling.<h4>Objective</h4>T...

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Autores principales:	Giulia Comunale, Massimo Padalino, Carmelo Maiorana, Giovanni Di Salvo, Francesca M Susin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c7b5d21f03e54b688b298fd856ba9400
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spelling	oai:doaj.org-article:c7b5d21f03e54b688b298fd856ba94002021-12-02T20:13:40ZVentricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.1932-620310.1371/journal.pone.0258225https://doaj.org/article/c7b5d21f03e54b688b298fd856ba94002021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258225https://doaj.org/toc/1932-6203<h4>Background</h4>Right (R) or left (L) ventricular outflow tract (VOT) obstruction can be either a dynamic phenomenon or a congenital anatomic lesion, which requires a prompt and optimal timing of treatment to avoid a pathological ventricular remodelling.<h4>Objective</h4>To develop a simple and reliable numerical tool able to relate the R/L obstruction size with the pressure gradient and the cardiac output. To provide indication of the obstruction severity and be of help in the clinical management of patients and designing the surgical treatment for obstruction mitigation.<h4>Methods</h4>Blood flow across the obstruction is described according to the classical theory of one-dimensional flow, with the obstruction uniquely characterized by its size. Hemodynamics of complete circulation is simulated according to the lumped parameter approach. The case of a 2 years-old baby is reproduced, with the occlusion placed in either the R/ or the L/VOT. Conditions from wide open to almost complete obstruction are reproduced.<h4>Results</h4>Both R/LVOT obstruction in the in-silico model resulted in an increased pressure gradient and a decreased cardiac output, proportional to the severity of the VOT obstruction and dependent on the R/L location of the obstruction itself, as it is clinically observed.<h4>Conclusion</h4>The in-silico model of ventricular obstruction which simulates pressure gradient and/or cardiac output agrees with clinical data, and is a first step towards the creation of a tool that can support the clinical management of patients from diagnosis to surgical treatments.Giulia ComunaleMassimo PadalinoCarmelo MaioranaGiovanni Di SalvoFrancesca M SusinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258225 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Giulia Comunale Massimo Padalino Carmelo Maiorana Giovanni Di Salvo Francesca M Susin Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
description	<h4>Background</h4>Right (R) or left (L) ventricular outflow tract (VOT) obstruction can be either a dynamic phenomenon or a congenital anatomic lesion, which requires a prompt and optimal timing of treatment to avoid a pathological ventricular remodelling.<h4>Objective</h4>To develop a simple and reliable numerical tool able to relate the R/L obstruction size with the pressure gradient and the cardiac output. To provide indication of the obstruction severity and be of help in the clinical management of patients and designing the surgical treatment for obstruction mitigation.<h4>Methods</h4>Blood flow across the obstruction is described according to the classical theory of one-dimensional flow, with the obstruction uniquely characterized by its size. Hemodynamics of complete circulation is simulated according to the lumped parameter approach. The case of a 2 years-old baby is reproduced, with the occlusion placed in either the R/ or the L/VOT. Conditions from wide open to almost complete obstruction are reproduced.<h4>Results</h4>Both R/LVOT obstruction in the in-silico model resulted in an increased pressure gradient and a decreased cardiac output, proportional to the severity of the VOT obstruction and dependent on the R/L location of the obstruction itself, as it is clinically observed.<h4>Conclusion</h4>The in-silico model of ventricular obstruction which simulates pressure gradient and/or cardiac output agrees with clinical data, and is a first step towards the creation of a tool that can support the clinical management of patients from diagnosis to surgical treatments.
format	article
author	Giulia Comunale Massimo Padalino Carmelo Maiorana Giovanni Di Salvo Francesca M Susin
author_facet	Giulia Comunale Massimo Padalino Carmelo Maiorana Giovanni Di Salvo Francesca M Susin
author_sort	Giulia Comunale
title	Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
title_short	Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
title_full	Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
title_fullStr	Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
title_full_unstemmed	Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
title_sort	ventricular outflow tract obstruction: an in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/c7b5d21f03e54b688b298fd856ba9400
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Ventricular outflow tract obstruction: An in-silico model to relate the obstruction to hemodynamic quantities in cardiac paediatric patients.

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