Med Biol Eng Comput - Patient-specific finite element modeling of the Cardiokinetix Parachute(?) device: effects on left ventricular wall stress and function.

Tópicos

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Resumo

The Parachute(?) (Cardiokinetix, Inc., Menlo Park, California) is a catheter-based device intended to reverse left ventricular (LV) remodeling after antero-apical myocardial infarction. When deployed, the device partitions the LV into upper and lower chambers. To simulate its mechanical effects, we created a finite element LV model based on computed tomography (CT) images from a patient before and 6 months after Parachute(?) implantation. Acute mechanical effects were determined by in silico device implantation (VIRTUAL-Parachute). Chronic effects of the device were determined by adjusting the diastolic and systolic material parameters to better match the 6-month post-implantation CT data and LV pressure data at end-diastole (ED) (POST-OP). Regional myofiber stress and pump function were calculated in each case. The principal finding is that VIRTUAL-Parachute was associated with a 61.2 % reduction in the lower chamber myofiber stress at ED. The POST-OP model was associated with a decrease in LV diastolic stiffness and a larger reduction in myofiber stress at the upper (27.1%) and lower chamber (78.4%) at ED. Myofiber stress at end-systole and stroke volume was little changed in the POST-OP case. These results suggest that the primary mechanism of Parachute(?) is a reduction in ED myofiber stress, which may reverse eccentric post-infarct LV hypertrophy.

Resumo Limpo

parachut cardiokinetix inc menlo park california catheterbas devic intend revers left ventricular lv remodel anteroap myocardi infarct deploy devic partit lv upper lower chamber simul mechan effect creat finit element lv model base comput tomographi ct imag patient month parachut implant acut mechan effect determin silico devic implant virtualparachut chronic effect devic determin adjust diastol systol materi paramet better match month postimplant ct data lv pressur data enddiastol ed postop region myofib stress pump function calcul case princip find virtualparachut associ reduct lower chamber myofib stress ed postop model associ decreas lv diastol stiff larger reduct myofib stress upper lower chamber ed myofib stress endsystol stroke volum littl chang postop case result suggest primari mechan parachut reduct ed myofib stress may revers eccentr postinfarct lv hypertrophi

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