HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mark B. Ratcliffe Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Guccione, J. M. Articles by Ratcliffe, M. B. Search for Related Content PubMed PubMed Citation Articles by Guccione, J. M. Articles by Ratcliffe, M. B. Related Collections Cardiac - physiology Congestive Heart Failure

J Thorac Cardiovasc Surg 2001;122:592-599
© 2001 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease (ACD)

Residual stress produced by ventricular volume reduction surgery has little effect on ventricular function and mechanics: A finite element model study

From the Departments of Surgery,^a Bioengineering,^b and Anesthesia,^c University of California, San Francisco, Calif.

This study was supported by National Institutes of Health grants R01-HL-58759 (Dr Guccione) and R01-HL-63348 (Dr Ratcliffe).

Received for publication Sept 18, 2000. Revisions requested Jan 5, 2001; revisions received Jan 30, 2001. Accepted for publication Feb 5, 2001. Address for reprints: Julius M. Guccione, PhD, Division of Surgical Services (112D), Department of Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121. (E-mail: Julius.Guccione@ med.va.gov).

Abstract

Objectives: Residual stress is the stress (force per unit area) that remains when all external loads (eg, left ventricular chamber and pericardial pressures) are removed. It has been suggested that ventricular volume reduction surgery can reconstitute the residual stress-strain state of the left ventricle. To determine the extent to which residual stress is involved, we used a mathematical (finite element) model to simulate the effect of volume reduction operations on left ventricular stroke volume/end-diastolic pressure (Starling) relationships, as well as on regional distributions of stress in the local muscle fiber direction (fiber stress).
Methods: The nonlinear stress-strain relationship for the diastolic myocardium was anisotropic with respect to the local muscle fiber direction. An elastance model for active fiber stress was incorporated in an axisymmetric geometric model of the dilated, poorly contractile left ventricular wall.
Results: When residual stress is implemented in the model simulation of volume reduction operations, the additional decrease in stroke volume at fixed left ventricular end-diastolic pressure is small (10% volume reduction: 2.0% at 1 mm Hg and 2.0% at 20 mm Hg; 20% volume reduction: 2.2% at 1 mm Hg and 3.1% at 20 mm Hg). Furthermore, there is little change in the mean fiber stress throughout the left ventricular wall (10% volume reduction: +1.0% at end-diastole and –0.3% at end-systole; 20% volume reduction: +2.1% at end-diastole and –1.0% at end-systole).
Conclusions: These results suggest that residual stress produced by volume reduction operations has little effect on left ventricular function and the mean fiber stresses at end-diastole and end-systole.

This article has been cited by other articles:

				J. C. Walker, M. B. Ratcliffe, P. Zhang, A. W. Wallace, E. W. Hsu, D. A. Saloner, and J. M. Guccione Magnetic resonance imaging-based finite element stress analysis after linear repair of left ventricular aneurysm. J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1094 - 1102.e2. [Abstract] [Full Text] [PDF]

				The effect of anteroapical aneurysm plication on end-systolic three-dimensional strain in the sheep: a magnetic resonance imaging tagging study. J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 579 - 586.e3.

				S. Hashim and D. Richens Finite element method in cardiac surgery Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 5 - 8. [Abstract] [Full Text] [PDF]

				P. Zhang, J. M. Guccione, S. I. Nicholas, J. C. Walker, P. C. Crawford, A. Shamal, D. A. Saloner, A. W. Wallace, and M. B. Ratcliffe Left ventricular volume and function after endoventricular patch plasty for dyskinetic anteroapical left ventricular aneurysm in sheep J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1032 - 1038. [Abstract] [Full Text] [PDF]

				A. B. C. Dang, J. M. Guccione, J. M. Mishell, P. Zhang, A. W. Wallace, R. C. Gorman, J. H. Gorman III, and M. B. Ratcliffe Akinetic myocardial infarcts must contain contracting myocytes: finite-element model study Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1844 - H1850. [Abstract] [Full Text] [PDF]

				J. C. Walker, J. M. Guccione, Y. Jiang, P. Zhang, A. W. Wallace, E. W. Hsu, and M. B. Ratcliffe Helical myofiber orientation after myocardial infarction and left ventricular surgical restoration in sheep J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 382 - 390. [Abstract] [Full Text] [PDF]

				A. B.C. Dang, J. M. Guccione, P. Zhang, A. W. Wallace, R. C. Gorman, J. H. Gorman III, and M. B. Ratcliffe Effect of Ventricular Size and Patch Stiffness in Surgical Anterior Ventricular Restoration: A Finite Element Model Study Ann. Thorac. Surg., January 1, 2005; 79(1): 185 - 193. [Abstract] [Full Text] [PDF]

				H. Tsuneyoshi, T. Nishina, T. Nomoto, H. Kanemitsu, R. Kawakami, O. Unimonh, K. Nishimura, and M. Komeda Atrial Natriuretic Peptide Helps Prevent Late Remodeling After Left Ventricular Aneurysm Repair Circulation, September 14, 2004; 110(11_suppl_1): II-174 - II-179. [Abstract] [Full Text] [PDF]

				J. M. Guccione, A. Salahieh, S. M. Moonly, J. Kortsmit, A. W. Wallace, and M. B. Ratcliffe Myosplint decreases wall stress without depressing function in the failing heart: a finite element model study Ann. Thorac. Surg., October 1, 2003; 76(4): 1171 - 1180. [Abstract] [Full Text] [PDF]

				J. R. Teerlink and M. B. Ratcliffe Ventricular remodeling surgery for heart failure: small animals and how to measure an improvement in ventricular function Ann. Thorac. Surg., May 1, 2002; 73(5): 1368 - 1370. [Full Text] [PDF]