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Giancarlo Pennati

Publications and source records attributed to Giancarlo Pennati.

14 recordsLinked to original sources
PubMed2005

Multiscale modelling in biofluidynamics: application to reconstructive paediatric cardiac surgery.

Multiscale computing is a challenging area even in biomechanics. Application of such a methodology to quantitatively compare postoperative hemodynamics in congenital heart diseases is very promising. In the treatment of hypoplastic left heart syndrome, which is a congenital heart disease where the left ventricle is missing or very small, the necessity to feed the pulmonary and systemic circulations is obtained with an interposition shunt. Two main options are available and differ from the sites of anastomoses: (i) the systemic-to-pulmonary conduit (Blalock-Taussig shunt known as the Norwood Operation (NO)) connecting the innominate artery (NO-BT) or the aorta (NO-CS) to the right pulmonary artery and (ii) the right ventricle to pulmonary artery shunt (known as Sano operation (SO)). The proposition that the SO is superior to the NO remains controversial. 3-D computer models of the NO (NO-BT and NO-CS) and SO were developed and investigated using the finite volume method. Conduits of 3, 3.5 and 4 mm were used in the NO models, whereas conduits of 4, 5 and 6 mm were used in the SO model. The hydraulic nets (lumped resistances, compliances, inertances and elastances) which represent the systemic, coronary and pulmonary circulations and the heart were identical in the two models. A multiscale approach was adopted to couple the 3-D models with the circulation net. Computer simulation results were compared with post-operative catheterization data. Results showed that (i) there is a good correlation between predicted and observed data: higher aortic diastolic pressure, decreased pulmonary arterial pressure, lower pulmonary-to-systemic flow ratio and higher coronary perfusion pressure in SO; (ii) there is a minimal regurgitant flow in the SO conduit. The close correlation between predicted and observed clinical data supports the use of mathematical modelling, with a mandatory multiscale approach, in the design and assessment of surgical procedures.

Algorithms↗
PubMed2005

Multiscale modeling of the cardiovascular system: application to the study of pulmonary and coronary perfusions in the univentricular circulation.

The objective of this study is to compare the coronary and pulmonary blood flow dynamics resulting from two configurations of systemic-to-pulmonary artery shunts currently utilized during the Norwood procedure: the central (CS) and modified Blalock Taussig (MBTS) shunts. A lumped parameter model of the neonatal cardiovascular circulation and detailed 3-D models of the shunt based on the finite volume method were constructed. Shunt sizes of 3, 3.5 and 4 mm were considered. A multiscale approach was adopted to prescribe appropriate and realistic boundary conditions for the 3-D models of the Norwood circulation. Results showed that the average shunt flow rate is higher for the CS option than for the MBTS and that pulmonary flow increases with shunt size for both options. Cardiac output is higher for the CS option for all shunt sizes. Flow distribution between the left and the right pulmonary arteries is not completely balanced, although for the CS option the discrepancy is low (50-51% of the pulmonary flow to the right lung) while for the MBTS it is more pronounced with larger shunt sizes (51-54% to the left lung). The CS option favors perfusion to the right lung while the MBTS favors the left. In the CS option, a smaller percentage of aortic flow is distributed to the coronary circulation, while that percentage rises for the MBTS. These findings may have important implications for coronary blood flow and ventricular function.

Blood Flow Velocity↗
PubMed2004

Simultaneous measurements of umbilical venous, fetal hepatic, and ductus venosus blood flow in growth-restricted human fetuses.

OBJECTIVE: The purpose of this study was to evaluate the changes in the distribution of the umbilical venous blood flow to the liver and to the ductus venosus in intrauterine growth-restricted human fetuses in relationship with dilation of the ductal isthmic diameter. STUDY DESIGN: Umbilical venous flow, ductus venosus blood flow, and blood flow to the fetal liver were measured in 56 severely intrauterine growth-restricted fetuses with an abnormal pulsatility index of the umbilical artery and were compared with 137 normal control fetuses. Percentages of umbilical venous blood flow through the ductus venosus and to the fetal hepatic lobes were calculated. Z-scores for control fetuses and intrauterine growth-restricted fetuses were constructed by the evaluation of the inverted smoothed percentiles. The distributions of the Z-scores was compared with a 1-sample t-test. RESULTS: The ductus venosus blood flow that was corrected for fetal weight was increased significantly in intrauterine growth-restricted fetuses compared with control fetuses (P=0); the median values (interquartile range) for comparable ages of gestation was 41.3 mL/min/kg (range, 26.2-64.0 mL/min/kg) and 30.8 mL/min/kg (range, 19.9-42.8 mL/min/kg), respectively. As a consequence, ductus venosus shunting was increased in intrauterine growth-restricted fetuses compared with control fetuses (P =0). In 23 of 30 intrauterine growth-restricted fetuses, the percentage of umbilical blood flow that was shunted through the ductus was>90th percentile of control fetuses. Ductal diameters were significantly greater in growth-restricted fetuses than in control fetuses (P =.0001). The percentage of blood flow to the right lobe showed a significant reduction (P =.0223), with evidence of reversed blood flow from the right lobe and portal system into the ductus venosus that was provided both by volume blood flow calculations and by direct pulsed Doppler waveform direction. CONCLUSION: In severe intrauterine growth-restricted fetuses, Doppler examination of blood flow volume proved a significant increase in the shunting of umbilical vein blood flow through the ductus venosus that was associated with the dilation of the ductal isthmic diameter. These changes provide a relatively constant blood flow to the heart and brain at the expense of fetal hepatic perfusion.

Adult↗
PubMed2004

Computational fluid dynamic study of flow optimization in realistic models of the total cavopulmonary connections.

OBJECTIVES AND BACKGROUND: In the Fontan circulation, pulmonary and systemic vascular resistances are in series. The influence of various inferior vena cava to pulmonary artery connections in this unique circulatory arrangement was evaluated using computation fluid dynamics methods. METHODS: Realistic three-dimensional models of total cavopulmonary connections were created from angiographic measurements to include the hepatic vein, superior vena cava, and branches of the pulmonary arteries. Steady-state finite volume analyses were performed using identical in vivo boundary conditions. Computational solutions calculated the percent hydraulic power dissipation and left-to-right pulmonary arterial flow distribution. RESULTS: Simulations of the lateral tunnel, intra-atrial tube, extracardiac conduit with left and right pulmonary artery anastomosis demonstrated extracardiac conduit with left pulmonary artery anastomosis having the lowest energy loss. Varying the extracardiac conduit from 10 to 30 mm resulted in the least energy dissipation at 20 mm. Serial dilation of the lateral tunnel pathway showed a small incremental worsening of energy loss. CONCLUSIONS: Maximizing energy conservation in a low-energy flow domain, such as the Fontan circulation, can be significant to its fluid dynamic performance. Although computational modeling cannot predict postoperative failure or functional outcome, this study confirms the importance of local geometry of the surgically created pathway in the total cavopulmonary connection.

Blood Vessel Prosthesis↗
PubMed2004

Mathematical modeling of fluid dynamics in pulsatile cardiopulmonary bypass.

The design criteria of an extracorporeal circuit suitable for pulsatile flow are quite different and more entangled than for steady flow. The time and costs of the design process could be reduced if mutual influences between the pulsatile pump and other extracorporeal devices were considered without experimental trial-and-error activities. With this in mind, we have developed a new lumped-parameter mathematical model of the hydraulic behavior of the arterial side of an extracorporeal circuit under pulsatile flow conditions. Generally, components feature a resistant-inertant-compliant behavior and the most relevant nonlinearities are accounted for. Parameter values were derived either by experimental tests or by analytical analysis. The pulsatile pump is modeled as a pure pulsatile flow generator. Model predictions were compared with flow rate and pressure tracings measured during hydraulic tests on two different circuits at various flow rates and pulse frequencies. The normalized root mean square error did not exceed 24% and the model accurately describes the changes that occur in the basic features of the pressure and flow wave propagating from the pulsatile pump to the arterial cannula.

Cardiopulmonary Bypass↗
PubMed2004

Biomechanical properties of human articular cartilage under compressive loads.

The function of articular cartilage is to support and distribute loads and to provide lubrication in the diarthrodial joints. Cartilage function is described by proper mechanical and rheological properties, strain and depth-dependent, which are not completely assessed. Unconfined and confined compression are commonly used to evaluate the Young's modulus (E) and the aggregate modulus (H(A)), respectively. The Poisson's ratio (nu) can be calculated indirectly from the equilibrium compression data, or using the biphasic indentation technique; it has recently been optically evaluated by using video microscopy during unconfined compression. The transient response of articular cartilage during confined compression depends on its permeability k; a constant value of k can be easily identified by a simple analytical model of confined compression tests, whereas more complex models or direct measurements (permeation tests) are needed to study the permeability dependence on deformation. A poroelastic finite element model of articular cartilage was developed for this purpose. The elastic parameters (E,nu) of the model were evaluated performing unconfined compression creep tests on human articular cartilage disks, whereas k was identified from the confined test response. Our combined experimental and computational method can be used to identify the parameters that define the permeability dependence on deformation, as a function of depth from articular surface.

Adaptation, Physiological↗
PubMed2002

Pressure drops in a distensible model of end-to-side anastomosis in systemic-to-pulmonary shunts.

The modified Blalock-Taussig shunt is a surgical procedure used as a palliation to treat complex congenital heart defects. It consists of an interposing prosthetic tube between the innominate/subclavian artery and the right pulmonary artery. Previous experience indicates that the pressure drop across the shunt is affected by the pulmonary pressure at the distal anastomosis combined with the distensibility of the anastomosis. In this study, a computational fluid-structure interaction approach is presented to investigate the haemodynamic behaviour. Steady-state fluid dynamics and structural analyses were carried out using commercial codes based on the finite element method (FIDAP and ABAQUS) coupled by means of a purposely-developed procedure to transfer boundary conditions. Both prosthetic tube and artery walls were characterised by non-linear material properties. Three different pulmonary pressures (2, 5 and 15 mmHg) and two volume flow rates (0.4 and 0.8 l/min) were investigated. Results indicate that the effects of distensibility at the distal anastomosis on the shunt pressure drop are relevant only when the distal anastomosis on the shunt pressure drop are relevant only when the distal anastomosis is not fully distended, which occurs when the pulmonary pressure is lower than 5 mmHg.

Algorithms↗
PubMedDate not supplied

Poroelastic numerical modelling of natural and engineered cartilage based on in vitro tests.

The mechanisms underlying the ability of articular cartilage to withstand and distribute the loads applied across diarthrodial joints have been widely studied. Experimental tests have been done under several configurations to reveal the tissue response to mechanical stimuli, and theoretical models have been developed for the interpretation of the experimental results. The experiments demonstrated that the tissue is non-linear with strain, both in tension and in compression, non-linear with direction of stimulus, anisotropic in tension and compression, non-homogeneous with depth, resulting in depth dependent mechanical properties, and presents fluid dependent and fluid independent viscoelasticity. None of the models up to now developed is able to describe the whole set of responses of such a complex tissue. The purpose of this study was to develop a combined experimental-numerical approach for the proper description of the cartilage response under confined and unconfined compression. We defined a series of experimental tests to be performed on disks of natural and engineered cartilage and we developed a numerical model for cartilage, based on the biphasic theory, which potentially includes the tension-compression non-linearity, the strain non-linearity and the fluid independent viscoelasticity. The model successfully simulated the confined and unconfined compression experiments performed on disks of natural and engineered cartilage, and was also used to identify parameters of difficult experimental evaluation, such as the collagen stiffness and the permeability. In conclusion, the use of our model in combination with biomechanical experimental testing seems a valuable tool to analyze the mechanical properties of natural cartilage and the biofunctionality of tissue engineered cartilage.

Aged↗