Fluid-Dynamic Modeling of the Human Left Ventricle: Methodology and Application to Surgical Ventricular Reconstruction Torsten Doenst, MD, PhD, Kathrin.

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Fluid-Dynamic Modeling of the Human Left Ventricle: Methodology and Application to Surgical Ventricular Reconstruction Torsten Doenst, MD, PhD, Kathrin Spiegel, MS, Michael Reik, MS, Michael Markl, PhD, Jürgen Hennig, PhD, Stefan Nitzsche, MD, Friedhelm Beyersdorf, MD, PhD, Herbert Oertel, PhD The Annals of Thoracic Surgery Volume 87, Issue 4, Pages 1187-1195 (April 2009) DOI: 10.1016/j.athoracsur.2009.01.036 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Schematic drawing of the Karlsruhe Heart Model (KaHMo; A) and the numeric grids obtained based on cardiac magnetic resonance imaging on a healthy volunteer (B). See Methods for description of grid generation. The Annals of Thoracic Surgery 2009 87, 1187-1195DOI: (10.1016/j.athoracsur.2009.01.036) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Schematic illustrations of the basic principles of blood viscosity (A), heart valve opening (B), and whole body circulation (C) as they are used for the modeling process. See Methods for details. (ascen = ascendent; descend = descendent; le = left; ri = right; VC = venae carae.) The Annals of Thoracic Surgery 2009 87, 1187-1195DOI: (10.1016/j.athoracsur.2009.01.036) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Comparison of simulated and directly visualized flow in a mock left ventricle and circulation model with flow patterns modeled using Karlsruhe Heart Model in the diastolic (upper panel) and systolic phase (lower panel). The Annals of Thoracic Surgery 2009 87, 1187-1195DOI: (10.1016/j.athoracsur.2009.01.036) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Long-axis cardiac magnetic resonance images of a heart from a healthy volunteer and a patient with dilated ventricle after myocardial infarction before and after surgical ventricular reconstruction. (Post-OP = postoperative; Pre-OP = preoperative.) The Annals of Thoracic Surgery 2009 87, 1187-1195DOI: (10.1016/j.athoracsur.2009.01.036) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Schematic drawing of blood flow through a healthy heart during one cardiac cycle (A), projection of streamlines in the long-axis plane after fluid dynamic modeling with the Karlsruhe Heart Model based on data from CMR imaging (B), and three-dimensional flow interpretation (C). The Annals of Thoracic Surgery 2009 87, 1187-1195DOI: (10.1016/j.athoracsur.2009.01.036) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Karlsruhe Heart Model flow simulations in the long-axis view from the healthy volunteer (upper row) and from the patient before (middle row) and after surgery (lower row). (Post-OP = postoperative; Pre-Op = preoperative.) The Annals of Thoracic Surgery 2009 87, 1187-1195DOI: (10.1016/j.athoracsur.2009.01.036) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions