The course deals with the development and use of the latest engineering methods for high-fidelity simulations of surgical and interventional treatments of the cardiovascular system. Applications are related to real-world goals that arise in the clinical scenario, and are mainly related to the optimization of surgical/interventional procedures, the evaluation of surgical/prosthetic device performances and, importantly, the training of clinicians towards a better understanding and execution of complex procedures.

The aim of the course is to provide attendees with the knowledge needed to understand or design and implement computational and experimental models, and with an integrated vision, encompassing advanced experimental methods, advanced computational methods, and their combination.

Concerning the experimental module, students are expected to:

i. learn and handle with confidence the lumped-parameter approach in the context of cardiovascular fluid dynamics and biomechanics, both as a tool for qualitative description, and as a technique for quantitative modelling;

ii. understand the basic criteria to turn the lumped-parameter models of cardiovascular fluid dynamics into real hydromechanical devices, suitable for performing laboratory evaluations;

iii. develop a specific sensitivity towards the use of biological samples combined with artificial lab devices, and the related implications in terms of feasibility, pros-and-cons, and design constraints.

Concerning the computational module, students are expected to:

i. learn and handle with confidence the concepts of solid mechanics that are relevant to modeling the mechanical response of cardiovascular tissues

ii. be familiar with the basic concepts of medical imaging and image processing that are to be exploited when reconstructing 3D geometrical models of cardiovascular structures

iii. understand how a finite element model works and what are the implications of different choices when defining a model of this kind.

A common goal for both modules is that students develop a critical and integrated mindset, allowing them to identify suitable modeling strategies and design criteria to simulate complex problems in the context of cardiovascular pathophysiology, cardiac surgery and interventional cardiology.

Section 1. Introductory concepts and motivations.

1.1. General requirements of a simulation environment for procedure optimization, device testing and/or training.

1.2. Traditional in-vivo animal testing and related limitations.

1.2. The current regulatory scenario.

Section 2. Experimental laboratory platforms.

2.1. Design specifications and methods for the development of mock circulatory loops.

2.2. Brief review of lumped-parameter modelling and its use in pulsatile hydrodynamic design.

2.3. The evolution from conventional test apparatuses to realistic phantoms.

2.4. Critical design of active and passive systems using ex-vivo anatomical samples.

2.5. Criteria for the practical setting-up and use of mock loops and phantoms in the laboratory: matching high-fidelity with practical goals.

Section 3. In-silico virtual phantoms.

3.1. Introduction to numerical modelling approaches.

3.2. Brief review of large strain theory and constitutive modeling for cardiovascular tissues.

3.3. Geometrical reconstruction of cardiovascular structures from medical imaging.

3.4. Realistic modeling of boundary conditions.

3.5. Criteria for the implementation of numerical models of surgical devices and procedures: matching high-fidelity with practical goals.

Section 4. Integration of experimental and computational methods.

4.1. Criteria for setting up integrated studies exploiting the complementarities of the two approaches.

4.2. Techniques for data integration: critical matching of quantitative information from different approaches.

4.3. The use of experiments for validation of  the models: analysis of real-world case studies.

4.4. The use of models for interpreting experimental data: analysis of real-world case studies.

Tutorials  and other activities

Class tutorials deal about the application to cases belonging to the real clinical world, including the simulation of recent catheter-based, minimally invasive and reparative cardiovascular procedures.
Laboratory visits are provided for, with practical demonstrations of real experimental and computational procedures.

Seminars will be given by professionals from the industrial and clinical arena.

For both modules, no prerequisite is mandatory.

Concerning the experimental module, basic concepts of hydraulics and a general knowledge about the behavior of simple dynamic systems will be of help for tackling the course topics.

Concerning the computational module, a sound background in calculus and continuum mechanics is highly desirable.

The final exam will consist in a written examination encompassing both modules and in an interview for each module. The written examinations and the interviews will all be in English.

The written examination will consist in ten multiple choice questions on the basic concepts taught during the course. A mark of at least 6/10 is required to access the interviews.

Candidates will be interviewed separately by the teachers of both modules. In each interview, the answers to the written text will be discussed to subsequently move to more complex topics. The goal of the interview will be twofold: on the one hand, assessing whether candidates have learned the theoretical and technical concepts taight in the classes; on the other hand, testing their capability to apply these concepts to tackle new problems.

The final evaluation will be the results of a discussion between the teachers, comparing the Candidate's knowledge in the topics of both modules. An insufficient evaluation in one module will preclude passing the exam.