Author + information
- Received November 5, 2008
- Revision received March 9, 2009
- Accepted March 24, 2009
- Published online August 1, 2009.
- Kartik S. Sundareswaran, MS⁎,
- Diane de Zélicourt, MS⁎,
- Shiva Sharma, MD†,
- Kirk R. Kanter, MD‡,
- Thomas L. Spray, MD§,
- Jarek Rossignac, PhD¶,
- Fotis Sotiropoulos, PhD#,
- Mark A. Fogel, MD∥ and
- Ajit P. Yoganathan, PhD⁎,⁎ ()
Reprint requests and correspondence:
Dr. Ajit P. Yoganathan, Wallace H. Coulter School of Biomedical Engineering, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, Georgia 30332-0535
The objectives of this study were to develop an image-based surgical planning framework that 1) allows for in-depth analysis of pre-operative hemodynamics by the use of cardiac magnetic resonance and 2) enables surgeons to determine the optimum surgical scenarios before the operation. This framework is tailored for applications in which post-operative hemodynamics are important. In particular, it is exemplified here for a Fontan patient with severe left pulmonary arteriovenous malformations due to abnormal hepatic flow distribution to the lungs. Patients first undergo cardiac magnetic resonance for 3-dimensional anatomy and flow reconstruction. After analysis of the pre-operative flow fields, the 3-dimensional anatomy is imported into an interactive surgical planning interface for the surgeon to virtually perform multiple surgical scenarios. Associated hemodynamics are predicted by the use of a fully validated computational fluid dynamic solver. Finally, efficiency metrics (e.g., pressure decrease and hepatic flow distribution) are weighted against surgical feasibility to determine the optimal surgical option.
- single ventricle congenital heart defects
- phase-contrast cardiac magnetic resonance
- computational fluid dynamics
Section Editor: Amir Lerman, MD
This work was supported by the NIH/NHLBI (grant HL67622), the NSF project (CBET-0625976), the Minnesota Supercomputing Institute, and an American Heart Association pre-doctoral fellowship. Drs. Sundareswaran and Zélicourt contributed equally to this work.
- Received November 5, 2008.
- Revision received March 9, 2009.
- Accepted March 24, 2009.
- American College of Cardiology Foundation