Clinical Validation of the PSCOPE Hybrid Model Prediction of Left Ventricular Assist Device Implantation Hemodynamics: Three Patient-Specific Cases
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Objective
The Physiology Simulation Coupled Experiment (PSCOPE) is a hybrid modeling framework designed for mechanistic cardiovascular predictive modeling. It couples a physical fluid experiment with a lumped parameter network simulation to replicate the closed-loop feedback between simulated cardiovascular physiology and fluid dynamics in the physical experiment. This study validates PSCOPE’s predictions of post-surgical physiology against clinical data in the context of HeartMate 3 left ventricular assist device implantation.
Methods
We designed a protocol to characterize the pre- and post-surgical hemodynamics of three adult HeartMate 3 patients using perioperative clinical measurements acquired from routine intensive care unit monitoring. For each patient, we tuned a lumped parameter network model to match their pre-surgical hemodynamic values, creating a patient-specific simulation of the pre-surgical physiology. The PSCOPE framework then modeled LVAD implantation by coupling these simulations to a physical HeartMate 3 device flow experiment. This hybrid model estimates physiological flow rate and pressure parameters to predict the patients’ post-surgical hemodynamics.
Results
The percentage difference between PSCOPE predictions and clinical post-surgical hemodynamics ranged from 0.0% to 44.7% across different hemodynamic parameters in different patients. The predicted cardiac index, mean pulmonary arterial pressure, central venous pressure, and pulmonary arterial wedge pressure together accurately indicated the absence of post-implant right ventricular failure in all patients.
Conclusion
This validation study demonstrates the potential of PSCOPE in assisting LVAD patient management. PSCOPE hemodynamic predictions could help clinicians anticipate and manage post-implant outcomes, such as right ventricular failure, thereby improving the efficacy of surgical planning.
