Simulation as a preoperative planning approach in advanced heart failure patients. A retrospective clinical analysis

Capoccia, Massimo and Marconi, Silvia and Singh, Sanjeet Avtaar and Pisanelli, Domenico M. and De Lazzari, Claudio (2018) Simulation as a preoperative planning approach in advanced heart failure patients. A retrospective clinical analysis. BioMedical Engineering Online, 17 (1). 52. ISSN 1475-925X

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    Abstract

    Background: Modelling and simulation may become clinically applicable tools for detailed evaluation of the cardiovascular system and clinical decision-making to guide therapeutic intervention. Models based on pressure-volume relationship and zero-dimensional representation of the cardiovascular system may be a suitable choice given their simplicity and versatility. This approach has great potential for application in heart failure where the impact of left ventricular assist devices has played a significant role as a bridge to transplant and more recently as a long-term solution for non eligible candidates. Results: We sought to investigate the value of simulation in the context of three heart failure patients with a view to predict or guide further management. CARDIOSIM© was the software used for this purpose. The study was based on retrospective analysis of haemodynamic data previously discussed at a multidisciplinary meeting. The outcome of the simulations addressed the value of a more quantitative approach in the clinical decision process. Conclusions: Although previous experience, co-morbidities and the risk of potentially fatal complications play a role in clinical decision-making, patient-specific modelling may become a daily approach for selection and optimisation of device-based treatment for heart failure patients. Willingness to adopt this integrated approach may be the key to further progress.