Pulmonary venous wedge pressure provides a safe and accurate estimate of pulmonary arterial pressure in children with shunt‐dependent pulmonary blood flow

Hill, Kevin D.; Janssen, Dana; Ohmstede, David; Doyle, Thomas P.

doi:10.1002/ccd.22084

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…Hence, P PA was evaluated by means of the pulmonary venous wedge pressure (PVWP). Although PVWP overall provides an accurate estimate of P PA , 9 1 to 3 mmHg uncertainty remains. Moreover, the high velocity and often turbulent flow characterizing the shunt region may cause MRI signal loss, leading to about 10% uncertainty in Q P measurement.…”

Section: Discussionmentioning

confidence: 98%

Integration of Clinical Data Collected at Different Times for Virtual Surgery in Single Ventricle Patients: A Case Study

Corsini¹,

Baker²,

Baretta³

et al. 2014

Ann Biomed Eng

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Newborns with single ventricle physiology are usually palliated with a multi-staged procedure. When cardiovascular complications e.g., collateral vessel formation occur during the inter-stage periods, further treatments are required. An 8-month-old patient, who underwent second stage (i.e., bi-directional Glenn, BDG) surgery at 4 months, was diagnosed with a major veno-venous collateral vessel (VVC) which was endovascularly occluded to improve blood oxygen saturations. Few clinical data were collected at 8 months, whereas at 4 months a more detailed data set was available. The aim of this study is threefold: (i) to show how to build a patient-specific model describing the hemodynamics in the presence of VVC, using patient-specific clinical data collected at different times; (ii) to use this model to perform virtual VVC occlusion for quantitative hemodynamics prediction; and (iii) to compare predicted hemodynamics with post-operative measurements. The three-dimensional BDG geometry, resulting from the virtual surgery on the first stage model, was coupled with a lumped parameter model (LPM) of the 8-month patient's circulation. The latter was developed by scaling the 4-month LPM to account for changes in vascular impedances due to growth and adaptation. After virtual VVC closure, the model confirmed the 2 mmHg BDG pressure increase, as clinically observed, suggesting the importance of modeling vascular adaptation following the BDG procedure.

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Section: Discussionmentioning

confidence: 98%

Integration of Clinical Data Collected at Different Times for Virtual Surgery in Single Ventricle Patients: A Case Study

Corsini¹,

Baker²,

Baretta³

et al. 2014

Ann Biomed Eng

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show abstract

“…If branch PA pressures were not available, mean pulmonary venous wedge pressure was used and averaged across all pulmonary veins where data were available. 5 , 6 For patients with RVPA, ΔP is the systolic PA pressure or systolic pulmonary venous wedge pressure subtracted from the systolic RV pressure.…”

Section: Methodsmentioning

confidence: 99%

Shunt resistance is associated with clinically important outcomes after the Norwood operation

et al. 2022

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“…The relation between PVWP and p a v is investigated in for single ventricle patients and in for children with shunt‐dependent pulmonary blood flow. Good agreement between PVWP and p a v is reported in where differences of −0.15 ± 1.31 mmHg are observed for patients with BT shunt not affected by pulmonary hypertension.…”

Section: Assessment Of Clinical Data Uncertaintymentioning

confidence: 99%

Uncertainty quantification in virtual surgery hemodynamics predictions for single ventricle palliation

Schiavazzi¹,

Arbia

Baker

et al. 2015

Numer Methods Biomed Eng

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The adoption of simulation tools to predict surgical outcomes is increasingly leading to questions about the variability of these predictions in the presence of uncertainty associated with the input clinical data. In the present study, we propose a methodology for full propagation of uncertainty from clinical data to model results that, unlike deterministic simulation, enables estimation of the confidence associated with model predictions. We illustrate this problem in a virtual stage II single ventricle palliation surgery example. First, probability density functions (PDFs) of right pulmonary artery (PA) flow split ratio and average pulmonary pressure are determined from clinical measurements, complemented by literature data. Starting from a zero-dimensional semi-empirical approximation, Bayesian parameter estimation is used to find the distributions of boundary conditions that produce the expected PA flow split and average pressure PDFs as pre-operative model results. To reduce computational cost, this inverse problem is solved using a Kriging approximant. Second, uncertainties in the boundary conditions are propagated to simulation predictions. Sparse grid stochastic collocation is employed to statistically characterize model predictions of post-operative hemodynamics in models with and without PA stenosis. The results quantify the statistical variability in virtual surgery predictions, allowing for placement of confidence intervals on simulation outputs.

show abstract

Pulmonary venous wedge pressure provides a safe and accurate estimate of pulmonary arterial pressure in children with shunt‐dependent pulmonary blood flow

Cited by 4 publications

References 18 publications

Integration of Clinical Data Collected at Different Times for Virtual Surgery in Single Ventricle Patients: A Case Study

Integration of Clinical Data Collected at Different Times for Virtual Surgery in Single Ventricle Patients: A Case Study

Shunt resistance is associated with clinically important outcomes after the Norwood operation

Uncertainty quantification in virtual surgery hemodynamics predictions for single ventricle palliation

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