We compared differences in the hemodynamic parameters of multiple surgical techniques for supravalvular aortic stenosis (SVAS). A three-dimensional model was reconstructed based on a patient\'s CT scan. Virtual McGoon, Doty, and Brom repairs were completed using computer-aided design (CAD). Hemodynamic parameters were calculated through computational fluid dynamics (CFD). The velocity profile and wall shear stress (WSS) showed the blood flow pattern. Energy loss (EL) and energy efficiency (EE) were calculated to estimate the cardiac workload. The perioperative blood flow ratio (BFR) of brachiocephalic vessels and coronary arteries was calculated. The preoperative flow velocity was abnormally high (> 5.0 m/s). High WSS was detected at the sinotubular junction (STJ), and its preoperative distribution in the aorta was uneven. High-speed flow disappeared after each of the three operations. The WSS distribution at the aortic root was consistent with the postoperative STJ structure of each operation. EL in the systolic phase decreased postoperatively (Original: 634 mW, McGoon: 218 mW, Doty: 278 mW, Brom: 255 mW). No significant difference in brachiocephalic BFR was detected among the different techniques. A slightly increased coronary BFR (Original: 7.56%, McGoon: 7.99%, Doty: 8.55%, Brom: 8.89%) was detected. McGoon, Doty, and Brom repair each effectively restored stable blood flow and greatly improved EE. The best WSS distribution and coronary blood supply were achieved after Brom repair due to its ability to reconstruct the symmetrical aortic root structure. CFD combined with a virtual operation is a promising method in surgical planning and optimization for SVAS.

UNASSIGNED: The aim of the research is to create an experimental data set of coronal section images of a human head.
UNASSIGNED: The head of a 49-year-old male cadaver was scanned by computed tomography (CT), then perfused with a green filling material via the bilateral common carotid artery, before being frozen and embedded. The head was sectioned along the coronal plane by a computer-controlled 5520 engraving and milling machine, capable of either 0.03-mm or 0.06-mm interspacing. All images were captured with a Canon 5D-Mk III digital camera.
UNASSIGNED: A total of 3854 section images were obtained, each with a resolution of 5760 × 3840 pixels. The number of section images at 0.03- and 0.06-mm interspacing were 1437 and 2417, respectively. All the images were stored in JPG and RAW formats. The image size of each RAW format was about 24.5 MB, whereas for JPG format, the equivalent size was about 5.9 MB. All the RAW and JPG images together occupied 117.35 GB of disk space.
UNASSIGNED: The interspacing of this data set section was thinner than those of any comparable studies, and the image resolution was higher, too. This data set was also the first to take coronal sections of the human head. The data set contains image information from the smallest structures within the human head and can satisfy the needs of future developments and applications, such as the virtual operation training systems for otolaryngology, ophthalmology, stomatology, and neurosurgery, and help develop medical teaching software and maps.

OBJECTIVE: To evaluate the feasibility and accuracy of virtual partial nephrectomy analysis, including a color-coded three-dimensional virtual surgical planning and a quantitative functional analysis, in predicting the surgical outcomes of robot-assisted partial nephrectomy.
METHODS: Between 2012 and 2014, 20 patients underwent virtual partial nephrectomy analysis before undergoing robot-assisted partial nephrectomy. Virtual partial nephrectomy analysis was carried out with the following steps: (i) evaluation of the arterial branch for selective clamping by showing the vascular-supplied area; (ii) simulation of the optimal surgical margin in precise segmented three-dimensional model for prediction of collecting system opening; and (iii) detailed volumetric analyses and estimates of postoperative renal function based on volumetric change. At operation, the surgeon identified the targeted artery and determined the surgical margin according to the virtual partial nephrectomy analysis. The surgical outcomes between the virtual partial nephrectomy analysis and the actual robot-assisted partial nephrectomy were compared.
RESULTS: All 20 patients had negative cancer surgical margins and no urological complications. The tumor-specific renal arterial supply areas were shown in color-coded three-dimensional model visualization in all cases. The prediction value of collecting system opening was 85.7% for sensitivity and 100% for specificity. The predicted renal resection volume was significantly correlated with actual resected specimen volume (r(2) = 0.745, P < 0.001). The predicted estimated glomerular filtration rate was significantly correlated with actual postoperative estimated glomerular filtration rate (r(2) = 0.736, P < 0.001).
CONCLUSIONS: Virtual partial nephrectomy analysis is able to provide the identification of tumor-specific renal arterial supply, prediction of collecting system opening and prediction of postoperative renal function. This technique might allow urologists to compare various arterial clamping methods and resection margins with surgical outcomes in a non-invasive manner.

OBJECTIVE: This study set out to design different types of total cavopulmonary connections (TCPC) with dual superior venae cavae (SVC), taking into account different sites for anastomosis from venae cavae to pulmonary arteries (PAs), and to compare haemodynamic features in these virtual operative designs.
METHODS: The geometries of bilateral bidirectional Glenn (BBDG) connection and inferior vena cava (IVC) connected extracardiac conduit were reconstructed to three-dimensional configurations according to the magnetic resonance images (MRIs) of two patients at the same age, and virtual operations were designed to create four possible TCPC models under the guidance of paediatric cardiac surgeons. Computational fluid dynamic (CFD) simulations were performed in each model at five predetermined pulmonary flow splits, to predict postoperative blood flows. The same boundary conditions were applied on each model, in order to simplify the analysis of the influence of configurations on the flow characteristics. Control volume power losses and energy efficiency in different models were calculated and compared. Flow patterns in the models were demonstrated by streamlines corresponding to the venae cavae.
RESULTS: When the flow rate of the right pulmonary artery (RPA) was 40-60% of the total pulmonary flow, control volume power loss was lower than the other three models in the model of TCPC 2 and was higher than the other three models in the model of TCPC 4.
CONCLUSIONS: For this patient, anastomosing the left superior vena cava (LSVC) and right superior vena cava (RSVC) on the PAs close together will cause higher power loss and lower energy efficiency in the TCPC connection. If the LSVC and RSVC had been connected to the PAs as near as possible to stimulate growth of the central PAs when performing I-stage BBDG procedure, the extracardiac conduit from IVC would be better connected just under the anastomotic site in the following TCPC procedure to avoid high power loss.