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Patient-specific finite element modeling of the Cardiokinetix….docx

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Patient-specific finite element modeling of the Cardiokinetix Parachute? device: Effects on left ventricular wall stress and function.Medical Biological Engineering ComputingOnline Resources 3LikChuan Lee1,2,4, PhD, Liang Ge, PhD1,2,4, Zhihong Zhang, MS4, Matthew Pease5, Serjan D. Nikolic5, PhD, Rakesh Mishra, MD3,4, Mark B. Ratcliffe, MD1,2,4 and Julius M. Guccione, PhD1,2,4From the Departments of Surgery1, Bioengineering2, and Medicine3, and from the University of California, San Francisco, California and the Veterans Affairs Medical Center, San Francisco, California4 and Cardiokinetix, Inc., Menlo Park, California5Corresponding Author: Mark B. Ratcliffe, MD, Division of Surgical Services (112), San Francisco Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, California 94121. Telephone: (415) 221-4810. FAX: (415) 750-2181. E-mail: Mark.Ratcliffe@va.govSensitivity of Results to a Change in ParametersTo assess the effects associated with a variation of the modeling input parameters, we performed a sensitivity analysis by perturbing the parameters individually in each of the 3 models described in the main text, namely, the PRE-OP, VIRTUAL-Parachute and POST-OP models. The effects on myofiber stress due to each individual perturbation are described in detail below.CHANGE IN MYOFIBER ORIENTATIONIn the original model, the myofiber orientation has a +60o/-60o configuration (i.e. a linear transmural variation from +60o at the endocardium to -60o at the epicardium). To assess the effects on myofiber stress associated with a change in myofiber orientation, we re-ran our simulations for the 3 cases withboth +35o/-35o and +85o/-85o myofiber orientation configurations (Fig. A1).The greatest percentage change in myofiber stress due to a change in myofiber orientation was -9.6%, andwas found in the upper chamber of the VIRTUAL-Parachute case with a +85o/-85o myofiber orientation (Table A1).Figure A: Myofiber orientation in the LV. Blue, red and green denote