Virtual Pulmonary Valve Replacement Interventions with a Personalised Cardiac Electromechanical Model

Pulmonary valve replacement (PVR) is a pivotal treatment for patients who suffer from chronic pulmonary valve regurgitations. Two PVR techniques are becoming prevalent: a minimally invasive approach and an open-heart surgery with direct right ventricle volume reduction. However, there is no common agreement about the postoperative outcomes of these PVR techniques and choosing the right therapy for a specific patient remains a clinical challenge. We explore in this paper how image processing algorithms, electromechanical models of the heart and real-time surgical simulation platforms can be adapted and combined together to perform patient-specific simulations of these two PVR therapies. We propose a framework where 1) an electromechanical model of the heart is personalised from clinical MR images and used to simulate the effects of PVR upon the cardiac function; 2) volume reduction surgery is simulated in real-time by interactively cutting, moving and joining parts of the anatomical model. The framework is tested on a young patient. The results are promising and suggest that such advanced biomedical technologies may help in decision support and surgery planning for PVR. 1 Asclepios, INRIA-Sophia-Méditerranée, Sophia-Antipolis, France [email protected] 2 Asclepios, INRIA-Sophia-Méditerranée, Sophia-Antipolis, France [email protected] Mauna Kea Technologies, Paris, France [email protected] 3 Siemens AG, CT SE SCR2, Erlangen, Germany 4 Asclepios, INRIA-Sophia-Méditerranée, Sophia-Antipolis, France [email protected] 5 Asclepios, INRIA-Sophia-Méditerranée, Sophia-Antipolis, France [email protected] 6 Service de Cardiologie Pédiatrique, Hôpital Necker Enfants Malades, Paris, France [email protected] 7 Asclepios, INRIA-Sophia-Méditerranée, Sophia-Antipolis, France [email protected] 2 Tommaso Mansi , Barbara André , Michael Lynch , Maxime Sermesant , Hervé Delingette , Younes Boudjemline and Nicholas Ayache