Despite the advances in imaging modalities and surgical techniques, the management of adults with congenital heart disease (ACHD) over the years has remained largely empirical rather than evidence-based. Animal models have been difficult to develop and very costly, while clinical trials are difficult to design and perform in ACHD, leaving gaps in our understanding of the pathophysiology and treatment of congenital heart disease. Disease modelling, both hypothetical and patient-specific, provides an alternative solution to many of these problems. Advances in cardiovascular imaging and diagnostics have led to the easy acquisition of large quantities of structural and functional information, which cannot be handled “intuitively”. Computational modelling introduces mathematical rigour in the analysis and utilisation of these data by quantitative simulation and testing of clinically relevant hypotheses through experimentally validated models. Close multidisciplinary collaboration between bioengineers and clinicians is essential for transforming data and images derived from models of disease into clinically useful information.
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- Congenital heart disease in adults. First of two parts.N Engl J Med. 2000; 342: 256-263
- The developmental genetics of congenital heart disease.Nature. 2008; 451: 943-948
- Pulmonary regurgitation: the effects of varying pulmonary artery compliance, and of increased resistance proximal or distal to it.Int J Cardiol. 2009; 133: 157-166
- Computational modeling of arterial biomechanics: insights into pathogenesis and treatment of vascular disease.J Vasc Surg. 2003; 37: 1118-1128
- Who should we operate on and how do we decide: predicting rupture and survival in patients with aortic aneurysm.Semin Vasc Surg. 2007; 20: 121-127
- Predicting the risk of rupture of abdominal aortic aneurysms by utilizing various geometrical parameters: revisiting the diameter criterion.Angiology. 2006; 57: 487-494
- Analysis of complex flow and relationship between blood pressure, wall shear stress and intima-media thickness in the human carotid artery.Am J Physiol Heart Circ Physiol. 2007; 293: H1031-1037
- Modeling the Fontan circulation: where we are and where we need to go.Pediatr Cardiol. 2008; 29: 3-12
- Nonlinear power loss during exercise in single-ventricle patients after the Fontan: insights from computational fluid dynamics.Circulation. 2007; 116: I165-171
- Total cavopulmonary connection flow with functional left pulmonary artery stenosis: angioplasty and fenestration in vitro.Circulation. 2005; 112: 3264-3271
- Simulations of congenital septal defect closure and reactivity testing in patient-specific models of the pediatric pulmonary vasculature: A 3D numerical study with fluid–structure interaction.J Biomech Eng. 2006; 128: 564-572
- Identification of vascular endothelial genes differentially responsive to fluid mechanical stimuli: cyclooxygenase-2, manganese superoxide dismutase, and endothelial cell nitric oxide synthase are selectively up-regulated by steady laminar shear stress.Proc Natl Acad Sci U S A. 1996; 93: 10417-10422
- Differential gene responses in endothelial cells exposed to a combination of shear stress and cyclic stretch.J Biotechnol. 2008; 133: 239-244
- Morphometry-based impedance boundary conditions for patient-specific modeling of blood flow in pulmonary arteries.Ann Biomed Eng. 2007; 35: 546-559
- Stratification of pediatric heart failure on the basis of neurohormonal and cardiac autonomic nervous activities in patients with congenital heart disease.Circulation. 2003; 108: 2368-2376
- Neurohormonal activation and the chronic heart failure syndrome in adults with congenital heart disease.Circulation. 2002; 106: 92-99
- Model of chronic adaptation: right ventricular function in Eisenmenger syndrome.Eur Heart J. 2007; 9: H54-H60
- Report of the National Heart, Lung, and Blood Institute Working Group on research in adult congenital heart disease.J Am Coll Cardiol. 2006; 47: 701-707
Tan FPP, Borghi A, Mohiaddin RH, Wood NB, Thom S, Xu XY. Analysis of flow patterns in a patient-specific thoracic aortic aneurysm model. Comput Struc, doi:10.1016/j.compstruc.2008.09.007.
Published online: December 01, 2008
Accepted: October 25, 2008
Received: July 31, 2008
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.