Multi-scale Modeling of Single Ventricle Hearts for Clinical Decision Support

5th Annual Meeting of the Leducq Foundation Network of Excellence

in Modeling of Single Ventricle Hearts

INRIA, Paris-Rocquencourt, France

May 22-24, 2014

Additional Information

 

The Trans-Atlantic Network of Excellence

Multi-Scale Modeling of Single Ventricle Hearts for Clinical Decision Support

What are we studying? A single ventricle heart is where the left or right side of the heart is severely underdeveloped. This is a congenital condition i.e. a child is born with the abnormality. Between the first few days of life and the early childhood years they require at least three operations to treat it. The end goal is to produce a heart that pumps blood both to the lungs and to the body. This heart functions with two chambers instead of the normal four. Often further interventions are needed as the child grows.

Why? The major challenge is that every child and every heart is different. There are many choices about the timing and type of operation. The best strategy for one child may not work as well for another as they grow and adapt differently. A computer model of a child’s heart would allow doctors to visualize the anatomy and may allow us to perform virtual operations to see the outcome of different surgeries. This would give physicians clinical decision support when making choices for each individual child.

How? Our network has extensive experience in research into congenital heart disease using engineering and computer science. We will use multi-scale modeling to develop a virtual model. We will collect clinical data from children with single ventricles using MRI, CT, echocardiography, and cardiac catheterization. Computer models will be constructed on a local scale (circulation in the heart and lungs) and global scale (whole body). These models will be tested for their ability to predict outcomes by comparing them to the clinical data from patients. Once these models have been validated then we will develop software for general clinical use. Our network is utilizing the strengths of pediatric cardiologists, surgeons, radiologists, engineers, and computer scientists from across the Atlantic to translate our research into a tool for clinical use.

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The Trans-Atlantic Network of Excellence for Cardiovascular Research :

Hypoplastic left heart syndrome (HLHS) is a congenital heart condition in which the left side of the heart is severely underdeveloped.  Children born with HLHS typically undergo three stages of corrective surgery during the first few years of life to enable the heart to function with only two chambers, instead of the usual four.  Additional interventions later in life are often required.  As is the case for most complex congenital heart conditions, choosing the appropriate treatment for HLHS is challenging because the severity of the anatomic abnormalities, as well as the circulatory changes that develop over time, are unique to each patient. A computer model that could allow physicians to simulate operations and observe their effects, using parameters specific to the patient in question, would thus be invaluable in guiding clinical decisions.

This network will create such a virtual model.  The network will acquire clinical data from HLHS patients using echocardiography, CT, MRI, and cardiac catheterization.  Computer models will be constructed on the local (cardiopulmonary circulation) as well as the global (incorporating the entire body) scale.  The network will then clinically validate the models and develop software for widespread use.  While it would be difficult for a single institution to assemble expertise in pediatric cardiology, surgery, imaging, engineering and computer science, formation of a transatlantic network leverages the combined strengths of the different investigators and institutions for such an ambitious multidisciplinary project.