Publication:
Computer-generated clinical decision-making in the treatment of pulmonary atresia with intact ventricular septum

dc.contributor.coauthorYildirim, Canberk
dc.contributor.coauthorDonmazov, Samir
dc.contributor.departmentDepartment of Mechanical Engineering
dc.contributor.departmentGraduate School of Sciences and Engineering
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorÖdemiş, Ender
dc.contributor.kuauthorPekkan, Kerem
dc.contributor.kuauthorUral, Berk
dc.contributor.schoolcollegeinstituteCollege of Engineering
dc.contributor.schoolcollegeinstituteGRADUATE SCHOOL OF SCIENCES AND ENGINEERING
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2025-03-06T20:57:43Z
dc.date.issued2024
dc.description.abstractPurpose: Pulmonary atresia with intact ventricular septum is a multifactorial disease requiring complex surgeries. The treatment route is determined based on the right ventricle (RV) size, tricuspid annulus size and coronary circulation dependency of RV. Since multiple parameters influence the post-operative success, a personalized decision-making based on computed hemodynamics is hypothesized to improve the treatment efficacy. Methods: A lumped parameter cardiovascular model is developed to calculate the hemodynamics of virtual patients which are generated by statistical distribution of circulation parameters. Four cohorts each with 30 digital patients are grouped based on RV size. For each patient, biventricular and one-and-half ventricle (1.5 V) repair were applied in silico and assessed via pressure, flow and saturations computed for every organ bed. Results: Biventricular and 1.5 V repair yield significant increase in the pulmonary flow and oxygen saturation for all patients compared to the pre-operative state (p-values andlt;0.001). Approximately 30% of generated patients failed to meet the sufficient saturation and flow following biventricular repair and were directed to 1.5 V repair. However, 14% of these 1.5 V repair patients failed post-operatively, requiring Fontan completion. Based on the pre-determined hemodynamics criteria, this study implies that patients having RV sizes larger than 22 ml/m2 are likely to undergo successful biventricular repair. Conclusion: Pending further clinical trials, computational pre-interventional planning has the potential to screen patients that would not optimally fit to the traditional pathway prior to in vivo execution by providing personalized hemodynamic outcome. Statistical approach allows in silico clinical trials, useful for diseases with low patient numbers. © The Author(s) under exclusive licence to Biomedical Engineering Society 2024.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipThis study was funded by ERC-PoC 966765 BloodTurbine research grant (KP).
dc.identifier.doi10.1007/s13239-024-00769-4
dc.identifier.eissn1869-4098
dc.identifier.grantno966765
dc.identifier.issn1869-408X
dc.identifier.quartileQ3
dc.identifier.scopus2-s2.0-85212482463
dc.identifier.urihttps://doi.org/10.1007/s13239-024-00769-4
dc.identifier.urihttps://hdl.handle.net/20.500.14288/27293
dc.identifier.wos1381681500001
dc.keywordsCardiovascular modeling
dc.keywordsCirculatory hemodynamics
dc.keywordsCongenital heart disease
dc.keywordsDigital twin
dc.keywordsNeonate
dc.keywordsPulmonary atresia with intact ventricular septum
dc.keywordsStatistical patient cohorts
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofCardiovascular Engineering and Technology
dc.subjectMedicine
dc.titleComputer-generated clinical decision-making in the treatment of pulmonary atresia with intact ventricular septum
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorPekkan, Kerem
local.contributor.kuauthorÖdemiş, Ender
local.contributor.kuauthorUral, Berk
local.publication.orgunit1College of Engineering
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1GRADUATE SCHOOL OF SCIENCES AND ENGINEERING
local.publication.orgunit2Department of Mechanical Engineering
local.publication.orgunit2School of Medicine
local.publication.orgunit2Graduate School of Sciences and Engineering
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