TY - GEN
T1 - Virtual surgical modification for planning tetralogy of Fallot repair
AU - Plasencia, Jonathan
AU - Babiker, Haithem
AU - Richardson, Randy
AU - Rhee, Edward
AU - Willis, Brigham
AU - Nigro, John
AU - Cleveland, David
AU - Frakes, David
PY - 2010
Y1 - 2010
N2 - Goals for treating congenital heart defects are becoming increasingly focused on the long-term, targeting solutions that last into adulthood. Although this shift has motivated the modification of many current surgical procedures, there remains a great deal of room for improvement. We present a new methodological component for tetralogy of Fallot (TOF) repair that aims to improve long-term outcomes. The current gold standard for TOF repair involves the use of echocardiography (ECHO) for measuring the pulmonary valve (PV) diameter. This is then used, along with other factors, to formulate a Z-score that drives surgical preparation. Unfortunately this process can be inaccurate and requires a mid-operative confirmation that the pressure gradient across the PV is not excessive. Ideally, surgeons prefer not to manipulate the PV as this can lead to valve insufficiency. However, an excessive pressure gradient across the valve necessitates surgical action. We propose the use of computational fluid dynamics (CFD) to improve preparation for TOF repair. In our study, pre-operative CT data were segmented and reconstructed, and a virtual surgical operation was then performed to simulate post-operative conditions. The modified anatomy was used to drive CFD simulation. The pressure gradient across the pulmonary valve was calculated to be 9.24mmHg, which is within the normal range. This finding indicates that CFD may be a viable tool for predicting post-operative pressure gradients for TOF repair. Our proposed methodology would remove the need for mid-operative measurements that can be both unreliable and detrimental to the patient.
AB - Goals for treating congenital heart defects are becoming increasingly focused on the long-term, targeting solutions that last into adulthood. Although this shift has motivated the modification of many current surgical procedures, there remains a great deal of room for improvement. We present a new methodological component for tetralogy of Fallot (TOF) repair that aims to improve long-term outcomes. The current gold standard for TOF repair involves the use of echocardiography (ECHO) for measuring the pulmonary valve (PV) diameter. This is then used, along with other factors, to formulate a Z-score that drives surgical preparation. Unfortunately this process can be inaccurate and requires a mid-operative confirmation that the pressure gradient across the PV is not excessive. Ideally, surgeons prefer not to manipulate the PV as this can lead to valve insufficiency. However, an excessive pressure gradient across the valve necessitates surgical action. We propose the use of computational fluid dynamics (CFD) to improve preparation for TOF repair. In our study, pre-operative CT data were segmented and reconstructed, and a virtual surgical operation was then performed to simulate post-operative conditions. The modified anatomy was used to drive CFD simulation. The pressure gradient across the pulmonary valve was calculated to be 9.24mmHg, which is within the normal range. This finding indicates that CFD may be a viable tool for predicting post-operative pressure gradients for TOF repair. Our proposed methodology would remove the need for mid-operative measurements that can be both unreliable and detrimental to the patient.
KW - Computational fluid dynamics
KW - Congenital heart disease
KW - Image processing
KW - Surgical planning
KW - Tetralogy of Fallot
UR - http://www.scopus.com/inward/record.url?scp=77952051689&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77952051689&partnerID=8YFLogxK
U2 - 10.1117/12.850773
DO - 10.1117/12.850773
M3 - Conference contribution
AN - SCOPUS:77952051689
SN - 9780819479266
T3 - Proceedings of SPIE - The International Society for Optical Engineering
BT - Proceedings of SPIE-IS and T Electronic Imaging - Computational Imaging VIII
T2 - Computational Imaging VIII
Y2 - 18 January 2010 through 19 January 2010
ER -