Patient-specific, dynamic models of Hypoplastic left heart syndrome tricuspid valves for simulation and planning

摘要

Physical replicas of patient specific heart valve pathologies may improve clinicians' ability to plan the optimal treatment for patients with complex valvular heart disease. Our previous work has demonstrated the ability to replicate patient pathology of the adult mitral valve (MV) in a dynamic environment. Infant congenital heart defects present possibly the most challenging form of valvular disease, given the range of pathologies, the relative size of these valves compared to adult anatomy, and the rarity of congenital heart disease. Patient specific valve models could be particularly valuable for pediatric cardiologists and surgeons, as a means to both plan for and practice interventions. Our current goal is to assess our ability to apply our workflow to the more challenging case of the tricuspid valve (TV) presented in cases of hypoplastic left heart syndrome (HLHS). We explore the feasibility of adapting our previous workflow for creating dynamic silicone MV models for pre-surgical planning and simulation training, to developing 3D echocardiogram derived, patient specific TV models for use in a physical heart simulator. These models are intended for characterization of the TV, and exploration of the relationship between specific anatomical features and tricuspid regurgitation (TR) severity. The simulations may be relevant to pre-surgical planning of repair of the particularly complex and unique anatomical pathologies presented in children with HLHS.