Computer-generated Clinical Decision-making in the Treatment of Pulmonary Atresia with Intact Ventricular Septum

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dc.authorid0000-0003-1041-6299
dc.authorid0000-0001-7637-4445
dc.authorid0000-0001-8814-3572
dc.contributor.authorYildirim, Canberk
dc.contributor.authorUral, Berk
dc.contributor.authorOdemis, Ender
dc.contributor.authorDonmazov, Samir
dc.contributor.authorPekkan, Kerem
dc.date.accessioned2026-04-04T18:55:25Z
dc.date.available2026-04-04T18:55:25Z
dc.date.issued2025
dc.departmentİstanbul Bilgi Üniversitesi
dc.description.abstractPurpose Pulmonary atresia with intact ventricular septum is a multifactorial disease requiring complex surgeries. The treatment route is determined based on the right ventricle (RV) size, tricuspid annulus size and coronary circulation dependency of RV. Since multiple parameters influence the post-operative success, a personalized decision-making based on computed hemodynamics is hypothesized to improve the treatment efficacy. Methods A lumped parameter cardiovascular model is developed to calculate the hemodynamics of virtual patients which are generated by statistical distribution of circulation parameters. Four cohorts each with 30 digital patients are grouped based on RV size. For each patient, biventricular and one-and-half ventricle (1.5 V) repair were applied in silico and assessed via pressure, flow and saturations computed for every organ bed. Results Biventricular and 1.5 V repair yield significant increase in the pulmonary flow and oxygen saturation for all patients compared to the pre-operative state (p-values < 0.001). Approximately 30% of generated patients failed to meet the sufficient saturation and flow following biventricular repair and were directed to 1.5 V repair. However, 14% of these 1.5 V repair patients failed post-operatively, requiring Fontan completion. Based on the pre-determined hemodynamics criteria, this study implies that patients having RV sizes larger than 22 ml/m(2) are likely to undergo successful biventricular repair. Conclusion Pending further clinical trials, computational pre-interventional planning has the potential to screen patients that would not optimally fit to the traditional pathway prior to in vivo execution by providing personalized hemodynamic outcome. Statistical approach allows in silico clinical trials, useful for diseases with low patient numbers.
dc.description.sponsorshipERC-PoC [966765]; European Research Council (ERC) [966765] Funding Source: European Research Council (ERC)
dc.description.sponsorshipThis study was funded by ERC-PoC 966765 BloodTurbine research grant (KP).
dc.identifier.doi10.1007/s13239-024-00769-4
dc.identifier.doi10.1007/s13239-024-00769-4
dc.identifier.endpage237
dc.identifier.issn1869-408X
dc.identifier.issn1869-4098
dc.identifier.issue2
dc.identifier.pmid39707136
dc.identifier.scopus2-s2.0-85212482463
dc.identifier.scopusqualityQ2
dc.identifier.startpage222
dc.identifier.urihttps://doi.org/10.1007/s13239-024-00769-4
dc.identifier.urihttps://hdl.handle.net/11411/10415
dc.identifier.volume16
dc.identifier.wosWOS:001381681500001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofCardiovascular Engineering and Technology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20260402
dc.snmzKA_Scopus_20260402
dc.subjectPulmonary Atresia With Intact Ventricular Septum
dc.subjectCardiovascular Modeling
dc.subjectStatistical Patient Cohorts
dc.subjectDigital Twin
dc.subjectCirculatory Hemodynamics
dc.subjectCongenital Heart Disease
dc.subjectNeonate
dc.titleComputer-generated Clinical Decision-making in the Treatment of Pulmonary Atresia with Intact Ventricular Septum
dc.typeArticle

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