Key result
Patient-specific MRI-based computational modeling of virtual surgeries showed good agreement with CMR measurements for predicting post-operative RV stroke volume and ejection ratio.
Why the study?
Does patient-specific MRI-based computational modeling accurately predict post-operative RV function in patients needing RV remodeling?
Does patient-specific MRI-based computational modeling accurately predict post-operative RV function in patients needing RV remodeling?
Patient-specific MRI-based computational modeling accurately predicts post-operative RV stroke volume and ejection fraction, offering a potential tool for optimizing surgical design in congenital heart disease.
May guide RV surgical planning in congenital heart disease; leaves open prospective outcome validation.
Right ventricular (RV) dysfunction is a common cause of heart failure in patients with congenital heart defects and often leads to impaired functional capacity and premature death. A novel surgical/modeling procedure is proposed to test the hypotheses that a) patient-specific image-based computational modeling can provide accurate information for assessment of RV function and that b) more aggressive scar removal using computer-aided surgery design with optimized post-operative RV morphology and patch design will lead to improved recovery of RV functions. Cardiac Magnetic Resonance (CMR) Imaging studies were performed in a dedicated MRI suite located in the Department of Cardiology at Children's Hospital Boston to acquire patient-specific ventricle geometry, heart motion, flow velocity, and flow rate for patients needing RV remodeling and pulmonary valve replacement operations before and after scheduled surgeries and healthy volunteers. MRI-based RV/LV combination models with fluid-structure interaction (FSI), RV-LV interaction, and RV-patch interaction were introduced to perform mechanical analysis and assess RV cardiac functions. The patient-specific FSI model (validated by pre-operation data) was used to predict possible outcome of virtual surgeries (i.e., with modified RV morphologies) and good agreement between computational predictions and pre-post operation RV stroke volume and ejection ratio as measured by CMR was found.
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Tang et al. (2007) studied Right ventricular dysfunction in congenital heart defects. Patient-specific virtual surgery using MRI-based 3D FSI RV/LV/Patch models was evaluated on RV stroke volume and ejection ratio. Patient-specific MRI-based computational modeling of virtual surgeries showed good agreement with CMR measurements for predicting post-operative RV stroke volume and ejection ratio.