Computer Modeling of Congenital Heart Disease
Computer Modeling of Congenital Heart Disease
This proposal is aimed at developing a novel method for modeling and analyzing clinical
 factors impacting RV function, which can lead to a more reliable, consistent, and
 comprehensive pre-operative treatment planning. In particular, the proposed work centers on
 the creation of an accurate and clinically useful heart model with which to quantify,
 visualize, and interpret several clinical findings that are central to the medical
 decision-making process. The hypothesis is that by providing clinicians with 3D models that
 capture numerous relevant patient findings in an integrated, quantitative manner they can
 make more consistent, reliable, and accurate clinical assessments and may also be able to
 predict factors complicit in RV dysfunction and impending failure.
The research proposed here is motivated by the need to support pediatric cardiologists in
 making image-based decisions in the assessment and management of congenital heart disease
 (CHD). In marked contrast to adult cardiology, which deals almost exclusively with the left
 ventricle (LV), the function of the RV is associated with a number of life-threatening
 conditions in pediatrics. These defects include Hypoplastic Left Heart Syndrome (HLHS),
 Congenitally Corrected Transposition of Great Arteries, Post operative Tetralogy of Fallot,
 and Double Outlet Right Ventricle.

 In particular, a computer model that simulates both the myocardium and blood pool of the
 right ventricle (RV) is being investigated that can be used to measure clinically useful but
 diverse parameters of RV blood flow and wall behaviors that previously would require multiple
 analysis tools to acquire. The model is based on data from MRI studies of patients. Alternate
 measurement techniques such as ultrasound and catheter pressure measurements are needed to
 verify the efficacy of the model.

 Through a retrospective chart review of CHD patients with defects associated with RV
 dysfunction, data will be obtained from CHOA over a five year period, June 1, 2001 through
 May 31, 2006. It will be collected from 10 children aged 0-18 years. Magnetic Resonance
 images, Ultrasound and catheterization measurements will be collected and analyzed.

 Data from MR will be used primarily to determine RV volumetric data. This information will be
 used to determine RV shape at the different stages of systole and through diastole. The RV
 shapes are the input to the computer model. The computer model will determine relevant
 clinical measures such as ejection fraction, pressure measurements, strain rate, and wall
 thickening based solely on the MR image data. The ultrasound and catheter data will be used
 as independent sources of verification against the data determined from the computer model.
 Ultrasound data will be used to compare ejection fraction and wall behavior to the predictive
 model and catheter data will be used to compare pressure measurements.
Inclusion Criteria:

 -  Choa patients only. Data will be taken from the following patient groups:

 -  Normal right ventricular (RV) EF with normal RV size and pulmonary insufficiency
 (PI)

 -  Normal RV EF with dilated RV and PI

 -  Reduced RV EF with dilated RV with PI

 -  Normal RV EF (pre-operatively) dilated RV and pulmonary valve

 -  replacement

 -  Reduced RV EF (pre-op) dilated RV and pulmonary valve replacement

 Exclusion Criteria:

 -  Those who do not conform with inclusion criteria