Virtual Pulmonary Valve Replacement Interventions with a Personalised Cardiac Electromechanical Model

Pulmonary valve replacement (PVR) is a pivotal treatment for patients who suffer from chronic pulmonary valve regurgitations. Two PVR techniques are becoming prevalent: a minimally invasive approach and an open-heart surgery with direct right ventricle volume reduction. However, there is no common agreement about the postoperative outcomes of these PVR techniques and choosing the right therapy for a specific patient remains a clinical challenge. We explore in this chapter how image processing algorithms, electromechanical models of the heart and real-time surgical simulation platforms can be adapted and combined together to perform patient-specific simulations of these two PVR therapies. We propose a framework where (1) an electromechanical model of the heart is personalised from clinical MR images and used to simulate the effects of PVR upon the cardiac function and (2) volume reduction surgery is simulated in real time by interactively cutting, moving and joining parts of the anatomical model. The framework is tested on a young patient. The results are promising and suggest that such advanced biomedical technologies may help in decision support and surgery planning for PVR.