Congenital heart disease
Congenital heart defects are the leading cause of infant mortality in the U.S. and represent various conditions affecting the cardiac chambers, valves, and peripheral blood vessels. In these patients, regular blood flow is restricted or perturbed, leading to dangerous levels of adverse cardiovascular remodeling and deoxygenation. Congenital heart patients display extremely heterogeneous anatomies. Even within the same condition, presentations of disease can be very different. This makes it important to consider patient-specific geometry when evaluating disease progression or potential treatments. We use our cardiovascular engineering tools to evaluate congenital heart disease diagnosis and treatment on a patient-specific basis. Using our simulation pipeline, we can create patient-specific models from cardiovascular images. Then, by simulating fluid dynamics in these models, we can investigate the biomechanics of disease progression, plan for surgical intervention, and optimize medical device design.
We have already used these tools to develop novel surgical methods, including the Fontan Y-graft and the Assisted Bidirectional Glenn for single-ventricle patients, and created novel methods for investigating biomechanical factors of disease progression in pulmonary hypertension. We have combined experimental and computational methods to understand valve performance in Tetralogy of Fallot and bicuspid valve patients. Other applications have included investigating surgical interventions for Williams and Alagille Syndromes.
Together, this represents a powerful suite of research that will help bring us into the future of congenital heart disease treatment.
Peripheral pulmonary artery stenosis
Peripheral pulmonary artery stenosis (PPS), single or multiple vessel narrowings in the pulmonary artery (PA) branches, can lead to right ventricular (RV) hypertension, RV failure, and pulmonary flow disparity. PPS is frequently seen in patients with Alagille syndrome, Williams syndrome, and Tetralogy of Fallot with pulmonary valve atresia and major aortopulmonary collateral arteries. Catheter-based interventions (stenting and angioplasty) for complex PPS are often ineffective at reducing RV pressure with poor outcomes. Surgical reconstruction can result in excellent outcomes but requires specialized expertise, which is available only at select institutions, and comprehensive surgical repair from central to segmental PAs. By working with Lucile Packard Children's Hospital at Stanford and UPMC Children's Hospital of Pittsburgh, we aim to develop modeling methods to predict treatment outcomes and optimize treatment strategies using fluid-structure interaction, vascular growth and remodeling, and uncertainty quantification techniques.