In silico medicine is transforming pediatric heart surgery by enabling personalized digital heart models. These models help surgeons plan procedures with precision, reducing complications. CFD simulations, already in use at Boston Children’s Hospital, are improving outcomes.
Every year, approximately 1.3 million newborns worldwide are born by congenital heart defects. For many of these infants, survival and good quality of life depend on life-saving cardiac surgeries performed within their first year of life.
Operating on a newborn’s heart is an extraordinary challenge. Their heart is tiny– just a few centimeters in size– requiring extreme surgical precision. This complexity is further amplified by the infant's fragility: with developing organs, sensitivity to anesthesia, and an underdeveloped immune system, the risk of severe complications is significantly elevated.
Another major challenge is growth: beyond operating in the first year of birth, surgeons must also anticipate how the child’s heart will develop over time. Thus, performing procedures that will remain effective for years to come. Improving surgical planning can enhance precision, reduce complications, and possibly prevent the need for additional surgeries. This is where in silico medicine plays a transformative role.
In silico medicine technologies employ engineering methods to create digital models of biological structures and functions. One such method is Computational Fluid Dynamics (CFD), which allows the study of the flow of a fluid. For decades, this tool has been successfully employed to predict, for instance, the aerodynamics of cars, planes, and spaceships, as well as optimising fluid movement in mechanical systems.
To physics, however, there’s no difference between a coolant moving through a pipeline of a spacecraft moving at high speed at the edge of Earth’s atmosphere, and the blood flowing through the chambers of the human heart. Using such a physics-based modelling of blood flow provides the opportunity to create the opportunity to create a personalised model of the human heart, enabling clinicians and researchers to study different medical conditions, as well as plan complex interventions with unprecedented accuracy.
With medical imaging techniques– including ultrasound, Computed Tomography, Magnetic resonance Imaging and advanced digital representation of the human body– clinicians can now create patient-specific virtual heart models. With such in silico models, they can investigate medical conditions to the finest detail, simulate possible treatments, evaluate different surgical approaches and predict the outcomes– all before stepping into the operating room.
What once seemed like science fiction is now a clinical reality. At the Boston Children’s Hospital, Dr. David Hoganson, a pediatric surgeon and director of the Computational 3D Visualisation Program, is already integrating CFD-powered 3D simulations into pediatric heart surgery planning. Dr. Hoganson’s team also includes modelling engineers, who are part of the hospital care team. They work alongside surgeons to create patient-specific computer models, which are then used by surgeons like Dr. Hoganson to test medical interventions, as well as plan the treatment.
The result? Tailor-made surgeries with greater precision and fewer complications. Additionally, these virtual models help medical teams to communicate effectively with patients and their families, as they provide a simple understanding of the disease state and treatment options.
Currently, Dr. Hoganson and colleagues are also sharing their experience to help other hospitals replicate this fruitful collaboration between clinicians and engineers.
With in silico medicine tools, surgeries on newborn children are being made safer and more precise, as talented surgeons increasingly leverage computer models. A wider adoption of such tools would also result in better access and wider availability of patient-specific procedures, reshaping the way we approach complex surgeries and improving the quality of care, for everyone.
References:
Boston Children's brings engineering precision to pediatric heart surgery;
Dr Hoganson: A Heart in the Right Place.
