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Effect of Adjustable Passive Constraint on the Failing Left Ventricle: A Finite-Element Model Study  Choon-Sik Jhun, PhD, Jonathan F. Wenk, PhD, Zhihong.

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Presentation on theme: "Effect of Adjustable Passive Constraint on the Failing Left Ventricle: A Finite-Element Model Study  Choon-Sik Jhun, PhD, Jonathan F. Wenk, PhD, Zhihong."— Presentation transcript:

1 Effect of Adjustable Passive Constraint on the Failing Left Ventricle: A Finite-Element Model Study 
Choon-Sik Jhun, PhD, Jonathan F. Wenk, PhD, Zhihong Zhang, MS, Samuel T. Wall, PhD, Kay Sun, PhD, Hani N. Sabbah, PhD, Mark B. Ratcliffe, MD, Julius M. Guccione, PhD  The Annals of Thoracic Surgery  Volume 89, Issue 1, Pages (January 2010) DOI: /j.athoracsur Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) Three-dimensional finite-element mesh of the unloaded dilated canine left ventricle, 16 × 5 × 1 (longitudinal × transmural × circumferential). (B) Cut-away view of the interior cavity and wall cross section. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Epicardial pressure loading profile; pressure (P) is 3, 5, 7, and 9 mm Hg (time points for end diastole [ED] and end systole [ES] are not drawn to scale). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 The effect of constraint on end-diastolic compliance; at baseline, 3, 5, 7, and 9 mm Hg of constraint. The compliance is shifted to the left as the level of passive constraint increases. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 The effect of adjustable passive constraint on the stroke volume–end-diastolic pressure (Starling) relationship at baseline, 3, 5, 7, and 9 mm Hg of constraint. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Mean volume-weighted end-diastolic fiber stress as the level of passive constraint increases. Fiber stress at end-diastole was reduced by 18.3% (inner wall), 15.3% (mid wall), and 14.2% (outer wall) at a constraint level of 2.3 mm Hg. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Relationship between stroke volume at initial end-diastolic pressure (17 mm Hg). Note that any amount of constraint is associated with a reduction in stroke volume. A line of 10% reduction in stroke volume occurs at 2.3 mm Hg. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

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