Simulating Cardiac Surgery for Children with Severe Congenital Heart Disease

摘要 先天性心脏病(CHD)影响了大约1.2%的儿童，是导致出生缺陷的主要原因。 相关死亡。单室性心脏病(SVHD)是一种严重的冠心病，发病率高，发病率高。 死亡率。这些患者需要多次姑息手术，最终进行全腔肺手术。 吻合。尽管SVHD患者的存活率有了相当大的改善，但有越来越多的 随着时间的推移，发病率和死亡率。目前尚不清楚为什么一些SVHD患者的手术修复失败 其他公司则保持相对较好的状况。临床医生通常依赖从以下来源获得的二维(2D)图像 超声心动图、插管或心血管磁共振(CMR)检查评估SVHD 并定性地选择最佳的手术修复方式。然而，2D图像导致了次优 理解复杂的三维空间关系和血流动力学，限制了有效的决策。 为了解决这一缺陷，开发了一种自由呼吸序列来获取 心脏和大血管在10分钟内完成。3D数据块将用于生成患者特定的脉搏 心脏模型。这个心脏模型将被用来模拟患者的心血管系统，具有集中的- 参数模型。集总参数模型将用于模拟不同的手术修复和 定量地为每个患者选择最优的修复方案。我们希望这个平台能够使 外科医生决定最佳的手术方式，并提高SVHD患者的存活率。

Abstract Congenital heart disease (CHD) affects approximately 1.2% of children and is the leading cause of birth defect- related deaths. Single ventricle heart disease (SVHD) is a severe form of CHD, with high morbidity and mortality. These patients require multiple palliative surgeries, culminating with a total cavopulmonary anastomosis. Despite considerable improvement in the survival of patients with SVHD, there is increasing morbidity and mortality over time. It remains unclear why some SVHD patients fail their surgical repairs while others remain relatively well. Clinicians often rely on 2-dimensional (2D) images acquired from echocardiograms, catheterizations, or cardiovascular magnetic resonance (CMR) exams to assess SVHD patients and qualitatively choose the optimal surgical repair. The 2D images, however, lead to a suboptimal understanding of the complex 3D spatial relationships and hemodynamics, and limit efficient decision making. To address this deficiency, a free-breathing sequence is developed to acquire 3D cine CMR images of the heart and great vessels in 10 minutes. The 3D block of data will be used to generate a patient-specific pulsatile heart model. This heart model will be used to simulate the patient cardiovascular system with a lumped- parameter model. The lumped-parameter model will be used to simulate different surgical repairs and quantitatively choose the most optimal repair for each patient. We expect that this platform rationalizes surgeons' decisions for the best surgical approach and improves the survival rate of patients with SVHD.