Single Ventricle Atrioventricular Valve Function
Single ventricle physiology (SVP) is used to describe any congenital heart lesion that is unable to support two independent pulmonary and systemic circulations. Recent decades have seen significant strides in the management of these patients. Survival in patients after the Fontan operation approaches 80% at 20 years. As encouraging as these results are, the single ventricle pathway is a palliative strategy and is not curative. While early-term mortality has decreased, late term mortality has not improved appreciably over the last two decades. The presence of atrioventricular regurgitation is a key predictor of failure, and the mortality risk persists even after transplant.
Complete atrioventricular canal defect
Another area of interest is complex intracardiac repair of complete atrioventricular canals. In the current surgical era, the double-patch (DP) and modified-single-patch (MSP) techniques are the most commonly performed repair strategies with mortality with long-term survival and freedom from reoperations being the main areas of interest. Atrioventricular valve regurgitation remains the most common cause of reoperation.
A better understanding of the underlying biomechanics and flow states can substantially further our understanding. These insights can inform the development of new therapeutic strategies for this complex patient population
Next-Generation Ex-Vivo Heart Simulator project aims to further our understanding of biomechanical forces and flow characteristics in various congenital heart lesions, in native pathophysiologic states and after therapeutic interventions. Soft silicone 3-D printed heart phantoms derived from MRI and CT data of various congenital heart defects are utilized. Emerging technologies in 3DCT, 4DFlow MRI and direct silicone additive printing allow for the creation and validation of high-fidelity models with compliances mimicking that of a normal or complex congenital heart. These ventricular morphologies will be merged with preliminary work to allow for precise modeling of complex congenital pathophysiologies and repair strategies.