BS14 Image-based computatinoal simulations of foetal heart function to understand congenital malformations and foetal heart intervention

Some Congenital Heart Malformations develops because of cardiac abnormalities during mid-gestation, which prevents normal development for the rest of gestation to lead to the malformation at birth. An example is foetal critical aortic stenosis, where an outflow obstruction causes high left ventricle (LV) pressures, low myocardial strains, and severe mitral regurgitation (MR). These abnormal conditions cause hypoplastic left heart Syndrome (HLHS) by birth in most cases, and are thus evolving HLHS cases. In such cases, catheter-based foetal aortic balloon valvuloplasty in utero interventions was shown to be promising in relieving the abnormal biomechanics, significantly reducing chances of single ventricular birth. However, the biomechanical nature of stenosis and intervention remain poorly characterized, even though they both have significant biomechanical effects. Further, our ability to predict outcomes of disease or intervention is very limited. We hypothesize that advanced image-based biomechanical simulations can improve our understanding, and can be used as a tool to better predict intervention outcomes. Here, we present preliminary work towards testing this hypothesis.