Hemodynamic Evaluation of a Novel Neuromodulation based Adaptive controller for Mitral Stenosis

Valvular heart disease (VHD) is an important cause of cardiovascular morbidity and mortality worldwide, affecting the aging population and also the younger population in the case of rheumatoid related valve disorders. In this paper, we present a simulation platform to study and do predictive analysis on valvular heart disease, Mitral stenosis (MS) in particular and propose a control approach to correct hemodynamic imbalances during severe MS conditions. Our developed cardiovascular hemodynamics model helps to create `what if' conditions to study the variation in different hemodynamic parameters like blood flow, aortic and ventricular pressure, etc. during normal and pathological conditions. In this aspect, we propose an adaptive control system in conjunction with the hemodynamic cardiovascular system (CVS) to handle hemodynamic disbalance during moderate to severe MS conditions. This controller is hypothesized in line with the neuro-modulation approach and modulates left ventricular contractility and vagal tone to counter the symptoms associated with MS. Simulation results indicate that the proposed controller has a significant effect in remodeling left ventricular dynamics and is theoretically capable of correcting hemodynamic conditions during severe MS.