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Shaffer A, Cogswell R, Devos A, Joseph N, Ramirez D, Prisco A, Iles T, Iazzo P, John R. CT Derived Three Dimensional Modeling to Facilitate Minimally Invasive HVAD to HeartMate3 Left Ventricular Assist Device Exchange. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Prisco AR, Aguado-Sierra J, Butakoff C, Vazquez M, Houzeaux G, Eguzkitza B, Bartos JA, Yannopoulos D, Raveendran G, Holm M, Iles T, Mahr C, Iaizzo PA. Concomitant Respiratory Failure Can Impair Myocardial Oxygenation in Patients with Acute Cardiogenic Shock Supported by VA-ECMO. J Cardiovasc Transl Res 2022; 15:217-226. [PMID: 33624260 PMCID: PMC7901681 DOI: 10.1007/s12265-021-10110-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/15/2021] [Indexed: 12/23/2022]
Abstract
Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment for acute cardiogenic shock in patients who also have acute lung injury predisposes development of a serious complication called "north-south syndrome" (NSS) which causes cerebral hypoxia. NSS is poorly characterized and hemodynamic studies have focused on cerebral perfusion ignoring the heart. We hypothesized in NSS the heart would be more likely to receive hypoxemic blood than the brain due to the proximity of the coronary arteries to the aortic annulus. To test this, we conducted a computational fluid dynamics simulation of blood flow in a human supported by VA-ECMO. Simulations quantified the fraction of blood at each aortic branching vessel originating from residual native cardiac output versus VA-ECMO. As residual cardiac function was increased, simulations demonstrated myocardial hypoxia would develop prior to cerebral hypoxia. These results illustrate the conditions where NSS will develop and the relative cardiac function that will lead to organ-specific hypoxia. Illustration of the impact of north-south syndrome on organ-specific oxygen delivery. Patients on VA-ECMO have two sources of blood flow, one from the VA-ECMO circuit and one from the residual cardiac function. When there is no residual cardiac function, all organs are perfused with oxygenated blood. As myocardial recovery progresses, blood supply from the two sources will begin to mix resulting in non-homogeneous mixing and differential oxygenation based upon the anatomical site of branching vessels.
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Affiliation(s)
- Anthony R Prisco
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Jazmin Aguado-Sierra
- Barcelona Supercomputing Center - Centro Nacional de Supercomputación, Barcelona, Spain
| | | | - Mariano Vazquez
- Barcelona Supercomputing Center - Centro Nacional de Supercomputación, Barcelona, Spain
| | - Guillaume Houzeaux
- Barcelona Supercomputing Center - Centro Nacional de Supercomputación, Barcelona, Spain
| | - Beatriz Eguzkitza
- Barcelona Supercomputing Center - Centro Nacional de Supercomputación, Barcelona, Spain
| | - Jason A Bartos
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Demetris Yannopoulos
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Ganesh Raveendran
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Mikayle Holm
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
- Department of Surgery, Visible Heart® Laboratories, University of Minnesota Medical School, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Tinen Iles
- Department of Surgery, Visible Heart® Laboratories, University of Minnesota Medical School, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Claudius Mahr
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Paul A Iaizzo
- Department of Surgery, Visible Heart® Laboratories, University of Minnesota Medical School, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
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Berman JP, Kaboudian A, Uzelac I, Iravanian S, Iles T, Iaizzo PA, Lim H, Smolka S, Glimm J, Cherry EM, Fenton FH. Interactive 3D Human Heart Simulations on Segmented Human MRI Hearts. Comput Cardiol (2010) 2021; 48:10.23919/cinc53138.2021.9662948. [PMID: 35754523 PMCID: PMC9228622 DOI: 10.23919/cinc53138.2021.9662948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Understanding cardiac arrhythmic mechanisms and developing new strategies to control and terminate them using computer simulations requires realistic physiological cell models with anatomically accurate heart structures. Furthermore, numerical simulations must be fast enough to study and validate model and structure parameters. Here, we present an interactive parallel approach for solving detailed cell dynamics in high-resolution human heart structures with a local PC's GPU. In vitro human heart MRI scans were manually segmented to produce 3D structures with anatomically realistic electrophysiology. The Abubu.js library was used to create an interactive code to solve the OVVR human ventricular cell model and the FDA extension of the model in the human MRI heart structures, allowing the simulation of reentrant waves and investigation of their dynamics in real time. Interactive simulations of a physiological cell model in a detailed anatomical human heart reveals propagation of waves through the fine structures of the trabeculae and pectinate muscle that can perpetuate arrhythmias, thereby giving new insights into effects that may need to be considered when planning ablation and other defibrillation methods.
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Affiliation(s)
- John P Berman
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
| | - Abouzar Kaboudian
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ilija Uzelac
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Tinen Iles
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Paul A Iaizzo
- Medical School, University of Minnesota, Minneapolis, MN, USA
| | | | | | | | - Elizabeth M Cherry
- School of Computational Science and Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Flavio H Fenton
- School of Physics, Georgia Institute of Technology, Atlanta, GA, USA
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Sanchez JZ, Burzotta F, Valenzuela T, Lassen JF, Iles T, Iaizzo PA. Direct Visualization of TAVR-Related Coronary Artery Management Techniques in Reanimated Beating Hearts. JACC Cardiovasc Interv 2021; 14:e87-e91. [PMID: 33958176 DOI: 10.1016/j.jcin.2021.02.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jorge Zhingre Sanchez
- Visible Heart Laboratories, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA; Medtronic Inc., Minneapolis, Minnesota, USA
| | - Francesco Burzotta
- Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Thomas Valenzuela
- Visible Heart Laboratories, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jens Flensted Lassen
- Department of Cardiology B, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Tinen Iles
- Visible Heart Laboratories, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Paul A Iaizzo
- Visible Heart Laboratories, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Holm M, Deakyne A, Gaasedelen E, Mattson A, Iles T, Iaizzo P. Using Virtual Reality to Study Real Patient Anatomy. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.02430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Shaffer A, Schinstock E, Bateman M, Iles T, Iaizzo P. Human Hearts Declined for Transplant Were Resuscitated on the Visible Heart® Apparatus. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Spratt JR, Mattison LM, Iaizzo PA, Meyer C, Brown RZ, Iles T, Panoskaltsis-Mortari A, Loor G. Lung transplant after prolonged ex vivo
lung perfusion: predictors of allograft function in swine. Transpl Int 2018; 31:1405-1417. [DOI: 10.1111/tri.13315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/06/2018] [Accepted: 07/04/2018] [Indexed: 12/11/2022]
Affiliation(s)
- John R. Spratt
- Department of Surgery; University of Minnesota; Minneapolis MN USA
| | - Lars M. Mattison
- Department of Surgery; University of Minnesota; Minneapolis MN USA
- Department of Biomedical Engineering; University of Minnesota; Minneapolis MN USA
| | - Paul A. Iaizzo
- Department of Surgery; University of Minnesota; Minneapolis MN USA
- Department of Biomedical Engineering; University of Minnesota; Minneapolis MN USA
- Department of Integrative Biology and Physiology; University of Minnesota; Minneapolis MN USA
- Institute for Engineering in Medicine; University of Minnesota; Minneapolis MN USA
| | - Carolyn Meyer
- Department of Pediatrics; University of Minnesota; Minneapolis MN USA
- Department of Medicine; University of Minnesota; Minneapolis MN USA
- Masonic Cancer Center; University of Minnesota; Minneapolis MN USA
| | - Roland Z. Brown
- Division of Biostatistics; University of Minnesota; Minneapolis MN USA
| | - Tinen Iles
- Department of Surgery; University of Minnesota; Minneapolis MN USA
- Department of Biomedical Engineering; University of Minnesota; Minneapolis MN USA
| | - Angela Panoskaltsis-Mortari
- Department of Pediatrics; University of Minnesota; Minneapolis MN USA
- Department of Medicine; University of Minnesota; Minneapolis MN USA
- Masonic Cancer Center; University of Minnesota; Minneapolis MN USA
| | - Gabriel Loor
- Division of Cardiothoracic Surgery; Department of Surgery; University of Minnesota; Minneapolis MN USA
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Loor G, Howard B, Iles T, Mattison L, Meyer P, Day T, Panoskaltsis-Mortari A, Kelly R, Iaizzo P. Prolonged Lung Preservation at 24 Hours Using Donor Whole Blood Perfusion in the Organ Care System (OCS). J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Schmidt MM, Iles T, Hernandez GA, Benscoter MA, Franz MR, Iaizzo PA. TCT-449 The Recording of Monophasic Action Potentials Simultaneously from both the Epicardial and Endocardial Surfaces of Porcine Hearts. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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