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Towards a digital twin of a growing fetal heart
Bettine van Willigen, Beatrijs van der Hout-van der Jagt, Wouter Huberts, Frans van de Vosse
Session: Poster Session 1 (Even numbers)
Session starts: Thursday 26 January, 16:00
Presentation starts: 16:00



Bettine van Willigen (Eindhoven University of Technology)
Beatrijs van der Hout-van der Jagt (Eindhoven University of Technology)
Wouter Huberts (Maastricht University)
Frans van de Vosse (Eindhoven University of Technology)


Abstract:
The Perinatal Life Support (PLS) consortium is developing a liquid-based environment (PLS system) to increase chance of survival of extremely preterm infants (< 28 weeks of gestational age). To develop such a complex device, knowledge from multidisciplinary fields must integrate into one single system. Mathematical models are used to support this integration by composing a digital twin of the PLS system and the preterm infant to allow computer simulations of the interaction with the device. The digital twin consists of a closed-loop fetal cardiovascular 0D circulation model connected to a 1D wave propagation model that describes the larger vessels. Furthermore, the contractile behaviour of the four cardiac chambers are included by a one fiber model1 for each of them. This model describes the underlying phenomena of cardiac contraction by relating cavity pressure to fiber stress, cavity and wall volume, and the geometrical inputs of this model makes it possible to simulate fetal cardiac growth without the need to redefine the contraction model. However, the mathematical models that describe the valve leaflet motion for 0D and 1D models2–4 seem not sufficient to allow fetal cardiac growth without fluttering of the valve leaflets. Part of the problem lies in the non-uniqueness of the parameter set of these models as these are chosen and tuned for a specific case. Therefore, these models do not always result in physiological realistic outcomes when growth of the cardiac valves are initiated based on scaling laws or when clinical data is used for its digital twin purpose. In this study a general formula describing three different 0D valve models at once has been developed: the ideal diode, the valve model of Mynard et al.2, and the valve model of Korakianitis and Shi4. These three models have all three a different assumption about the relation between the pressure drop over and flow through the valve. Furthermore, these valves describe motion of the valve leaflets differently. By performing a sensitivity analysis5 on the general description of these valves, the importance of the parameters and the relation between the parameters can be identified. Furthermore, the correctness of the assumptions can be analysed. Ultimately, a valve model can be defined that describes the underlying phenomena of fetal cardiac valves in order to allow digital twinning and, thus, fetal cardiac growth.