Key result
In silico digital twin modeling of MVP™ deployment in 7 neonates revealed marked variability in pulmonary artery stiffness and local contact pressure distributions despite identical diameters.
Patient-specific computational modeling using a validated digital twin can feasibly simulate endovascular pulmonary flow restrictor deployment in neonates and uncover substantial variability in arterial stiffness and local contact pressures.
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Patient-specific simulations reveal variable pulmonary artery stiffness and contact pressures after MVP deployment; leaves open whether this framework can guide individualized transcatheter banding in neonates.
Introduction Transcatheter pulmonary flow restriction using a modified Medtronic Vascular Plug (MVP™) has recently emerged as a promising alternative to surgical pulmonary arterial banding in neonates with complex congenital heart defects. However, clinical outcomes remain variable, and the underlying biomechanical mechanisms are poorly understood. This study aims to exploit in silico modeling to improve the understanding of device–artery interactions following the deployment of modified MVP™ in neonatal pulmonary arteries. To this end, we (i) developed and validated a high-fidelity digital twin of an MVP™ device, and (ii) used clinical imaging data from a retrospective cohort of seven neonates treated at Boston Children’s Hospital to reproduce in silico the in vivo device–artery interaction in both the right and left pulmonary arteries. Methods The digital twin was reconstructed from high-resolution optical measurements and mechanically characterized under both local and global compression. Idealized artery geometries were generated based on pre-procedural angiographic measurements. For each patient, wall thickness was varied within a size-adjusted range derived from the literature, while Young’s modulus was calibrated to reproduce the post-implantation arterial diameters, thereby quantifying the vessel’s stiffness in response to device expansion. Results Case-specific simulations revealed marked variability in pulmonary artery effective stiffness across patients and between arterial branches. While identical post-implantation diameters could be reproduced through different thickness–stiffness combinations, these generated substantially different local contact pressure distributions. Conclusions This study demonstrates the feasibility of a patient-specific computational framework for simulating the deployment of endovascular pulmonary flow restrictors using a validated MVP™ digital twin.
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Bonfanti et al. (2026) studied Neonates with complex congenital heart defects (n=7). In silico digital twin simulation of modified Medtronic Vascular Plug (MVP™) deployment was evaluated on Simulated device–artery interaction, pulmonary artery effective stiffness, post-implantation arterial diameters, and local contact pressure distributions. In silico digital twin modeling of MVP™ deployment in 7 neonates revealed marked variability in pulmonary artery stiffness and local contact pressure distributions despite identical diameters.
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