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A Simulink model of the pediatric cardiovascular system following Stage I surgical palliation of hypoplastic left heart syndrome / Jeremy S. Touroo.

by Touroo, Jeremy S.

Hypoplastic Left Heart Syndrome -- surgery

Numerical analysis -- Data processing

Models, Cardiovascular

Computer simulation

Infant, Newborn.

115 leaves : ill. ; 29 cm.

Thesis advisor: Dr. Jeffrey LaMack

Committee members: Dr. Larry Fennigkoh, Dr. Ronald Gerrits

Introduction -- Background -- Materials and methods -- Results -- Discussion -- A: Simulink model details: top-level system -- B: Simulink model details: Heart and vascular subsystems -- C: Simulink model details: oxygen calculations -- D: Simulink blocks.

Hypoplastic left heart syndrome is a rare congenital heart abnormality that involves hypoplasia of left-sided cardiac structures such as the aortic valve, left ventricle, mitral valve, and ascending aorta, and the condition is unvaryingly fatal unless immediate treatment is provided. An alternative to complete cardiac transplantation is surgical reconstruction of the neonatal circulation performed in three separate stages. The intent of the initial surgical stage, referred to as the Norwood procedure, is to achieve adequate blood flow in both the systemic and pulmonary vascular beds with only one functional ventricle. The purpose of this study was to develop a comprehensible, software-based model of the Norwood circulation that can be used to improve understanding of the complex physiology resulting from the palliative operation. To accomplish this, a previously documented mathematical model of the Norwood circulation was implemented as a graphical user interface in Simulink, thus forming a user-friendly software environment for efficient quantitative and qualitative hemodynamic analysis. Published clinical data obtained from Norwood operation patients were utilized for model validation. Simulation of the Simulink model produced results that correlate well with the clinical data and with information found in the literature, indicating that the model is a valid tool for studying trends and behaviors associated with the Norwood circulation. Specifically, the model may be useful for analyzing hemodrynamic responses to various inputs, exploring prospective treatment methods prior to clinical experimentation, and comparing different surgical strategies. Additionally, the model may be an effective preoperative planning aid, particularly in a case consisting of unique or unfamiliar patient physiology. A further objective of this research was to adjust the Norwood model so that it represents the pediatric circulation following the Sano modification, which is an alternative option for first-stage palliation of hypoplastic left heart syndrome, and to simulate the experimental model as a preliminary investigation of system performance. The results of the simulation, which show consistency with pertinent research reports, imply that constructing a valid model of the Sano modification from the Simulink model of the Norwood circulation described in this study is a viable path for future research.

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