Computational modeling and engineering in pediatric and congenital heart disease.
OBJECTIVE
Recent methodological advances in computational simulations are enabling increasingly realistic simulations of hemodynamics and physiology, driving increased clinical utility. We review recent developments in the use of computational simulations in pediatric and congenital heart disease, describe the clinical impact in modeling in single-ventricle patients, and provide an overview of emerging areas.


RESULTS
Multiscale modeling combining patient-specific hemodynamics with reduced order (i.e., mathematically and computationally simplified) circulatory models has become the de-facto standard for modeling local hemodynamics and 'global' circulatory physiology. We review recent advances that have enabled faster solutions, discuss new methods (e.g., fluid structure interaction and uncertainty quantification), which lend realism both computationally and clinically to results, highlight novel computationally derived surgical methods for single-ventricle patients, and discuss areas in which modeling has begun to exert its influence including Kawasaki disease, fetal circulation, tetralogy of Fallot (and pulmonary tree), and circulatory support.


CONCLUSIONS
Computational modeling is emerging as a crucial tool for clinical decision-making and evaluation of novel surgical methods and interventions in pediatric cardiology and beyond. Continued development of modeling methods, with an eye towards clinical needs, will enable clinical adoption in a wide range of pediatric and congenital heart diseases.
aDepartments of Pediatrics and Bioengineering, Institute for Computational and Mathematical Engineering bDepartments of Pediatrics and Bioengineering, Stanford University, Stanford, California, USA.
Alison L
AL
Marsden
Jeffrey A
JA
Feinstein
D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation / Q000639:trends*; D006330:Heart Defects, Congenital / Q000473:pathology / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities*; D006439:Hemodynamics; D006801:Humans; D010372:Pediatrics; D057285:Precision Medicine / Q000639:trends