Simona Celi

Fondazione Toscana Gabriele Monasterio · BioCardioLab

Extracorporeal Membrane Oxygenation (ECMO) is a modality of extracorporeal life support which allows temporary support in cases of cardiopulmonary failure and cardiogenic shock. This study presents a valveless pump that works by the Liebau effect as a possible pumping system in ECMO circuits, replacing the current roller and centrifugal pumps. For...

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Recent developments in Artificial Intelligence have increasingly focused on explainability research. The potential of Explainable Artificial Intelligence (XAI) in producing trustworthy computer-aided diagnosis systems and its usage for knowledge discovery are gaining interest in the medical imaging (MI) community to support the diagnostic process a...

Background Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide and require extensive investigation through in-vitro studies. Mock Circulatory Loops (MCLs) are advanced in-vitro platforms that accurately replicate physiological and pathological hemodynamic conditions, while also allowing for precise and patient-specif...

Purpose This study aims to develop a realistic 3D printing-based simulator for the training and planning of the left atrial appendage occlusion (LAAO) to be used in the cath lab. Design/methodology/approach Starting from a pre-operative computed tomography dataset of a patient already treated with LAAO, the model was obtained, consisting in the ri...

Photon counting computed tomography (PCCT) represents a paradigm shift from conventional CT imaging, propelled by a new generation of X-ray detectors capable of counting individual photons and measuring their energy. The first part of this narrative review is focused on the technical aspects of PCCT and describes its key advancements and benefits c...

The last wave of Artificial Intelligence is dedicating particular emphasis to the line of explainability research. The potential of Explainable Artificial Intelligence (XAI) in producing trustworthy computer-aided-diagnosis systems and its usage for knowledge discovery are collecting interest in the Medical Imaging (MI) community to support the dia...

This research introduces an innovative method for the early screening of cardiorespiratory diseases based on an acquisition protocol, which leverages commodity smartphone's Inertial Measurement Units (IMUs) and deep learning techniques. We collected, in a clinical setting, a dataset featuring recordings of breathing kinematics obtained by accelerom...

Introduction Three-dimensional printed models are widely used in the medical field for surgical and interventional planning. In the context of complex cardiovascular defects such as pediatric congenital heart diseases (CHDs), the adoption of 3D printed models could be an effective tool to improve decision-making. In this paper, an investigation was...

Background and Objective: The introduction of photon-counting computed tomography (PCCT) represents the most recent groundbreaking advancement in clinical computed tomography (CT). PCCT has the potential to overcome the limitations of traditional CT and to provide new quantitative imaging information. This narrative review aims to summarize the tec...

Time-resolved three-dimensional flow MRI (4D flow MRI) provides a unique non-invasive solution to visualize and quantify hemodynamics in blood vessels such as the aortic arch. However, most current analysis methods for arterial 4D flow MRI use static artery walls because of the difficulty in obtaining a full cycle segmentation. To overcome this lim...

The left atrial appendage occlusion (LAAO) is a recommended treatment for atrial fibrillation (AF) patients unable to take anti-coagulation therapy. However, the occurrence of thromboembolic events after LAAO have an incidence up to 16%. In this study, computational fluid dynamics (CFD) was used to investigate the hemodynamic effects of different d...

Spectral Photon-Counting Computed Tomography (SPCCT) represents a groundbreaking advancement in X-ray imaging technology. The core innovation of SPCCT lies in its photon-counting detectors, which can count the exact number of incoming x-ray photons and individually measure their energy. The first part of this review summarizes the key elements of S...

The remote monitoring of clinical parameters plays a fundamental role in different situations, like pandemic health emergencies and post-surgery conditions. In these situations, the patients might be impeded in their movements, and it could be difficult to have specific health monitoring. In recent years, technological advances in smartphones have...

Left atrial appendage occlusion (LAAO) is a percutaneous procedure to prevent thromboembolism in patients affected by atrial fibrillation. Despite its demonstrated efficacy, the LAA morphological complexity hinders the procedure, resulting in postprocedural drawbacks (device‐related thrombus and peri‐device leakage). Local anatomical features may c...

Penetrating aortic ulcer (PAU) represents a subset of acute aortic syndromes characterized by high rupture risk and management challenges, particularly in elderly patients with significant comorbidities. This case report showcases a 75-year-old patient with a history of coronary artery bypass graft (CABG) and with multiple PAUs involving the aortic...

The remote monitoring of clinical parameters plays a fundamental role in different situations, like pandemic health emergencies and post-surgery conditions. In these situations, the patients might be impeded in their movements and it could be difficult to have a specific health monitoring. In recent years, technological advancements in smartphones...

The multimodal and multidomain registration of medical images have gained increasing recognition in clinical practice as a powerful tool for fusing and leveraging useful information from different imaging techniques and in different medical fields such as cardiology and orthopedics. Image registration could be a challenging process, and it strongly...

The treatment for asthma and chronic obstructive pulmonary disease relies on forced inhalation of drug particles. Their distribution is essential for maximizing the outcomes. Patient-specific computational fluid dynamics (CFD) simulations can be used to optimize these therapies. In this regard, this study focuses on creating a parametric model of t...

The venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a widely adopted procedure to provide oxygenated blood support in patients who underwent cardiac shock. The current work presents a study to define a correlation between VA-ECMO support level and both systemic pressure and arterial perfusion. In this work, a numerical approach is def...

The impact of the distribution in space of the inlet velocity in the numerical simulations of the hemodynamics in the thoracic aorta is systematically investigated. A real healthy aorta geometry, for which in-vivo measurements are available, is considered. The distribution is modeled through a truncated cone shape, which is a suitable approximation...

Background Abdominal Aortic Aneurysm (AAA) is a balloon-like dilatation that can be life-threatening if not treated. Fabricating patient-specific AAA models can be beneficial for in-vitro investigations of hemodynamics, as well as for pre-surgical planning and training, testing the effectiveness of different interventions, or developing new surgica...

Photon-counting computed tomography (PCCT) is an emerging technology that can potentially transform clinical CT imaging. After a brief description of the PCCT technology, this review summarizes its main advantages over conventional CT: improved spatial resolution, improved signal and contrast behavior, reduced electronic noise and artifacts, decrea...

Statistical Shape Models (SSMs) are well-established tools for assessing the variability of 3D geometry and for broadening a limited set of shapes. They are widely used in medical imaging due to their ability to model complex geometries and their high efficiency as generative models. The principal step behind these techniques is a registration phas...

The acquisition of insights concerning the mechanobiology of aneurysmatic aortic tissues is an important field of investigation. The complete characterization of aneurysm mechanical behaviour can be carried out by biaxial experimental tests on ex vivo specimens. In literature, several works proposed bulge inflation tests as a valid method to analys...

We report on a 2-week-old infant with huge left main coronary artery-to-right ventricular outflow tract fistula causing myocardial ischemia due to global coronary steal who was successfully submitted to percutaneous closure guided by a 3-dimensional–printed model using a duct-occluder vascular plug. (Level of Difficulty: Advanced.)

Photon-counting computed tomography (PCCT) is an emerging technology that is expected to radically change clinical CT imaging. PCCT offers several advantages over conventional CT, which can be combined to improve and expand the diagnostic possibilities of CT angiography. After a brief description of the PCCT technology and its main advantages we wi...

The photon-counting detector (PCD) is a new computed tomography detector technology (photon-counting computed tomography, PCCT) that provides substantial benefits for cardiac and coronary artery imaging. Compared with conventional CT, PCCT has multi-energy capability, increased spatial resolution and soft tissue contrast with near-null electronic n...

Photon-counting detector (PCD) is a novel computed tomography detector technology (photon-counting computed tomography—PCCT) that presents many advantages in the neurovascular field, such as increased spatial resolution, reduced radiation exposure, and optimization of the use of contrast agents and material decomposition. In this overview of the ex...

In the context of aortic hemodynamics, uncertainties affecting blood flow simulations hamper their translational potential as supportive technology in clinics. Computational fluid dynamics (CFD) simulations under rigid-walls assumption are largely adopted, even though the aorta contributes markedly to the systemic compliance and is characterized by...

Multiple valve heart disease refers to the simultaneous presence of several valvular anomalies, while mixed valvular heart disease refers to the combination of stenotic lesions or regurgitation affecting the same valve. The pathophysiology of multiple and mixed valvular heart disease depends on the combination of affected valves and the severity of...

Rapidly evolving health digital technologies are changing modern healthcare in unprecedented ways [...]

We perform a stochastic sensitivity analysis of the experimental setup of a mock circulatory loop for in vitro hemodynamics analysis in the ascending thoracic aorta at a patient-specific level. The novelty of the work is that, for the first time, we provide a systematic sensitivity analysis of the effect of the inflow conditions, viz. the stroke vo...

Background Blood speckle tracking echocardiography allows for direct quantification of interventricular and aortic flow profiles, principally in children. Here, we sought to demonstrate the feasibility and reproducibility of blood speckle tracking echocardiography in the aortas of healthy children. Methods and Results One hundred healthy White chi...

Tetralogy of Fallot (ToF) is the most common congenital heart disease. In this work, hemodynamics of pulmonary arteries (PA) in ToF patients was investigated using patient-specific image-based models. The study included the investigation of right and left pulmonary arteries (RPA and LPA, respectively). Numerical and experimental tools were used to...

Introduction: Patient-specific computational models are a powerful tool for planning cardiovascular interventions. However, the in vivo patient-specific mechanical properties of vessels represent a major source of uncertainty. In this study, we investigated the effect of uncertainty in the elastic module (E) on a Fluid-Structure Interaction (FSI)...

The analysis of mechanobiology of arterial tissues remains an important topic of research for cardiovascular pathologies evaluation. In the current state of the art, the gold standard to characterize the tissue mechanical behavior is represented by experimental tests, requiring the harvesting of ex-vivo specimens. In recent years though, image-base...

Background: To say data is revolutionising the medical sector would be a vast understatement. The amount of medical data available today is unprecedented and has the potential to enable to date unseen forms of healthcare. To process this huge amount of data, an equally huge amount of computing power is required, which cannot be provided by regular...

Background and Objective The introduction of photon-counting computed tomography (PCCT) represents the most recent groundbreaking advancement in clinical computed tomography (CT). PCCT has the potential to overcome the limitations of traditional CT and to provide new quantitative imaging information. This narrative review aims to summarize the tech...

Goal: This work presents the development of a Hybrid Mock Circulatory Loop (HMCL) to simulate hemodynamics at patient-specific level in terms of both 3D geometry and inlet/outlet boundary conditions. Methods: Clinical data have been processed to define the morphological and functional patient-specific settings. A piston pump is used to impose a...

Pediatric idiopathic aortic aneurysm is rare. Single saccular malformation can complicate native or recurrent aortic coarctation; however, multiloculated dilatations of the descending thoracic aorta, associated with aortic coarctation, have so far never been described in literature. In our case, printed 3D model technology was crucial in planning t...

This report presents an overview of available and emerging non-animal models in the field of cardiovascular disease (CVD) research. Over 14,000 abstracts published between 2013 and 2019 were scanned for relevant non-animal methods for CVD. From these, 449 publications were identified as candidate methods according to selected inclusion/exclusion cr...

Magnetic resonance imaging (MRI) is the preferred modality to assess hemodynamics in healthy and diseased blood vessels. As an affordable and non-invasive alternative, Color-Doppler imaging is a good candidate. Nevertheless, Color-Doppler acquisitions provide only partial information on the blood velocity within the vessel. In this work, we present...

Background: In the context of a growing demand for the use of in silico models to meet clinical requests, image-based methods play a crucial role. In this study, we present a parametric equation able to estimate the elasticity of vessel walls, non-invasively and indirectly, from information uniquely retrievable from imaging. Methods: A custom equat...

The Modified Blalock Taussig Shunt (MBTS) is one of the most common palliative operations in case of cyanotic heart diseases. Thus far, the decision on the position, size, and geometry of the implant relies on clinicians’ experience. In this paper, a Medical Digital Twin pipeline based on reduced order modeling is presented for fast and interactive...

Minimally invasive aortic valve replacement is performed by mini-sternotomy (MS) or less invasive right anterior mini-thoracotomy (RT). The possibility of adopting RT is assessed by anatomical criteria derived from manual 2D image analysis. We developed a semi-automatic tool (RT-PLAN) to assess the criteria of RT, extract other parameters of surgic...

A comparison between the results obtained integrating in-vivo measurements in numerical simulations and in-vitro experiments is presented. Three aorta geometries are considered: a patient-specific healthy aorta, an aneurysmal aorta, and a coarctated aorta, both derived from the former geometry. Hemodynamic simulations are carried out by using the o...

Mitral regurgitation is one of the most common valvular heart diseases and is mainly caused by dilatation of the valvular annulus as a result of remodelling of the left ventricle. Transcatheter techniques have been developed as an alternative to standard surgical procedures to correct mitral valve regurgitation in patients at high surgical risk. Th...

Numerical simulations to evaluate thoracic aortic hemodynamics include a computational fluid dynamic (CFD) approach or fluid-structure interaction (FSI) approach. While CFD neglects the arterial deformation along the cardiac cycle by applying a rigid wall simplification, on the other side the FSI simulation requires a lot of assumptions for the mat...

Fluid-Structure Interaction (FSI) can be investigated by means of non-linear Finite Element Models (FEM), suitable to capture large deflections of structural parts interacting with fluids, and Computational Fluid Dynamics (CFD). High fidelity simulations are obtained using the fine spatial resolution of both the structural and fluid computational g...