第53回日本小児循環器学会総会・学術集会

講演情報

シンポジウム

シンポジウム 10 (II-S10)
小児循環器領域のシミュレーション医療:将来の可能性と限界

2017年7月8日(土) 14:00 〜 15:30 第7会場 (2F 研修交流センター 音楽工房ホール)

座長:板谷 慶一(京都府立医科大学 心臓血管外科・心臓血管血流解析学講座)
座長:白石 公(国立循環器病研究センター 小児循環器科)
共催:アンシス・ジャパン株式会社
共催:シーメンスヘルスケア株式会社
共催:マテリアライズジャパン株式会社

14:00 〜 15:30

[II-S10-03] Simulation Medicine and Blood Flow Imaging Developed in Japan

Keiichi Itatani1, Masaaki Yamagishi2, Takako Miyazaki2, Nobuyoshi Maeda2, Satoshi Taniguchi2, Shuhei Fujita2, Hisayuki Hongu2, Satoshi Numata1, Sachiko Yamazaki1, Tomoya Inoue1, Kazuki Morimoto1, Suguru Ohira1, Kaichiro Manabe1, Rina Makino1, Hiroko Morichi1, Kosuke Nakaji3, Kei Yamada3, Shohei Miyazaki4, Toyoki Furusawa4, Teruyasu Nishino4, Hitoshi Yaku1 (1.Department of Cardiovascular Surgery, Cardiovascular Imaging Research Labo. Kyoto Prefectural University of Medicine, Japan, 2.Department of Pediatric Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Japan, 3.Department of Radiology, Kyoto Prefectural University of Medicine, Japan, 4.Cardio Flow Design Inc., Japan)

Background: Recent progress in imaging and computer technology has provided novel imaging technology in cardiovascular medicine: simulation medicine. Simulation medicine is a kind of “virtual therapy” based on imaging or hemodynamic data. Because congenital heart disease has complicated anatomy and physiology, simulation medicine has been applied in the earliest days in cardiology especially related to the hemodynamics of Fontan circulation. I introduce the recent development of simulation medicine and blood flow imaging in Japan.
Method and Results: Blood flow imaging is based on several modalities. We has developed echocardiography blood flow visualization software VFM (vector flow mapping), which visualizes vortex flow patterns and evaluates its efficiency. 4D flow MRI is another noninvasive flow visualization tool, which has advantages on evaluation in the right ventricle. CFD (computational fluid dynamics) is a computer flow calculation tool, and patient specific CFD model not only provides detail information of hemodynamics, but also enables virtual surgery in a computer. We have developed a CFD model that realizes physiological flow. Flow energy loss is a parameter of cardiac workload and is a predictor of ventricular deterioration, and wall shear stress (WSS) is a stress on intima, and abnormal WSS causes intimal thickening or dilatation.
Conclusions: Several types of blood flow imaging and simulation medicine are developed in Japan. Evaluation of blood flow in patients with long-term after arch repair, RVOTR, and Fontan procedures is a good application for these new technologies.