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In silico Design of Novel Surgical Methods for Children with Single Ventricle Hearts: From Computation to Clinic
We invite you to join us for an informative discussion of translating simulation-based surgical procedures into the clinic.
Speaker: Dr. Alison Marsden, U.C. San Diego Time: Thursday, January 22, 2015 at 10:00 a.m. PST Registration: Registration is free but is required. Click here] to register.
Abstract - Single ventricle heart patients are among the most challenging patients for pediatric cardiologists to treat. These conditions, which are uniformly fatal without surgical intervention, result in a host of morbidities including cyanosis, exercise intolerance, arrhythmias, and heart failure. Patients typically undergo three-staged surgical repair starting in the neonatal period to route the venous return directly to the pulmonary arteries, separating the systemic and pulmonary circulations. Our recent work has combined shape optimization and multiscale modeling to design novel surgical procedures for the first and third stages of single ventricle repair.
In this talk, we will discuss our approach for promoting clinical adoption of these simulation-based surgical procedures through two case studies. First, we will discuss our Y-graft design for the Fontan surgery (the stage three surgery). Simulations show that our optimized Y-graft design has led to improvements in hepatic flow distribution, an important clinical parameter related to lung development. We will discuss our experiences and challenges with clinical translation, including follow up data from a clinical pilot study of 6 patients at Lucile Packard Children’s Hospital. Second, we will describe a newly proposed procedure called the Assisted Bidirectional Glenn (ABG), which has the potential to combine the first and second stage surgeries into one, reducing the number of required surgeries from three to two. Preliminary results from simulations demonstrate reduced cardiac workload and increased oxygen delivery, suggesting that the ABG holds promise for further investigation. Building on our experiences with the Y-graft, we will discuss lessons learned and plans for clinical translation of the ABG concept. We will outline plans for testing in an animal model and in vitro experimental models, steps that will enable future clinical translation. We will conclude by discussing some barriers specific to clinical translation in pediatrics, including ethical issues and small patient cohorts, and offer potential solutions.
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