支持单心室生理学手术决策的计算模型

Q2 Medicine
Tain-Yen Hsia MD , Timothy Conover PhD , Richard Figliola PhD , for the Modeling of Congenital Hearts Alliance (MOCHA) Investigators
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引用次数: 6

摘要

先天性心脏手术的许多进步都是建立在从模型模拟中获得的经验教训和见解之上的。虽然动物和模拟电路模型历来是测试新手术技术和概念的主要场所,但认识到复杂的心血管解剖和循环可以用数学方法建模,开创了外科医生和工程师之间合作的新时代。1996年,伦敦和米兰的研究人员利用计算机模拟了丰坦手术,并对手术进行了改进,从而开启了先天性心脏手术的计算时代。从那时起,随着数值和成像方法的不断完善和进步,计算模型在心外科手术中做出了许多贡献,进一步完善了解剖和生理细节的能力。理想的通用模型已经让位于对三维解剖、重建循环、受影响的血流动力学和改变的生理的精确的患者特异性模拟。对于一些最复杂的缺陷,例如那些需要单心室姑息治疗的缺陷,已经开发出了进行虚拟手术和预测血流动力学和循环结果的工具。在当今对个性化医疗和精确护理的追求中,计算建模在复杂的先天性心脏手术中辅助手术计划的作用将继续增长和发展。随着外科医生和工程师之间日益密切的合作,以及对建模局限性的清晰理解,计算模拟可以成为支持术前手术决策的有价值的辅助手段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Computational Modeling to Support Surgical Decision Making in Single Ventricle Physiology

Many of the advances in congenital heart surgery were built upon lessons and insights gained from model simulations. While animal and mock-circuit models have historically been the main arena to test new operative techniques and concepts, the recognition that complex cardiovascular anatomy and circulation can be modeled mathematically ushered a new era of collaboration between surgeons and engineers. In 1996, the computational age in congenital heart surgery began when investigators in London and Milan tapped the power of the computer to simulate the Fontan procedure and introduced operative improvements. Since then, computational modeling has led to numerous contributions in congenial heart surgery as continuing sophistication and advances in numerical and imaging methods furthered the ability to refine anatomic and physiologic details. Idealized generic models have given way to precise patient-specific simulations of the 3-dimensional anatomy, reconstructed circulation, affected hemodynamics, and altered physiology. Tools to perform virtual surgery, and predict flow dynamic and circulatory results, have been developed for some of the most complex defects, such as those requiring single ventricle palliation. In today's quest for personalized medicine and precision care, computational modeling's role to assist surgical planning in complex congenital heart surgery will continue to grow and evolve. With ever closer collaboration between surgeons and engineers, and clear understanding of modeling limitations, computational simulations can be a valuable adjunct to support preoperative surgical decision making.

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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
7
期刊介绍: The Pediatric Cardiac Surgery Annual is a companion to Seminars in Thoracic and Cardiovascular Surgery . Together with the Seminars, the Annual provides complete coverage of the specialty by focusing on important developments in pediatric cardiac surgery. Each annual volume has an expert guest editor who invites prominent surgeons to review the areas of greatest change in pediatric cardiac surgery during the year. Topics include 1) Complete Atrioventricular Canal; 2) New Concepts of Cardiac Anatomy and Function -- The Helical Heart; 3) Valve Reconstruction (Replacement) in Congenital Heart Disease; 4) Evolving Developments in Congenital Heart Surgery.
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