NSW Health and Medical Research

Improving new cardiac procedures with advanced computer simulation

University of New South Wales

Grant:
  • Cardiovascular Early-Mid Career Researcher Grant
Organ System:
  • Cardiovascular
Date Funded:
  • 22 May, 2020
Chief Investigator/s:
  • Dr. James Otton

Project summary

Using computer simulation to practice heart surgery using different valve sizes, positions and techniques.

What is the issue for NSW?

Heart procedures are changing. Valve replacement used to be done with open heart surgery and bypass. More and more, heart valves are being replaced by a small wire or catheter inserted from the arteries and veins at the top of the leg. These minimally invasive catheter procedures can be safe, allow faster recovery, and reduce costs to the health system.

The mitral valve is the most commonly diseased heart valve, but currently there is a problem with catheter-based procedures to replace it. Because the cardiologist can’t see the valve and is operating via X-ray and a wire, the valve has to be perfectly sized before the operation, and placed to fit each patient individually. The valve can also block the flow of blood out of the heart, resulting in a catastrophic loss of blood pressure. Because of this potential complication, up to 60% of patients referred for a catheter mitral valve replacement are refused the procedure.

What does the research aim to do and how?

The team has developed a method to create an exact 3D model of a patient’s heart from a CT scan. Using computer simulation, the team can practice heart surgery using different valve sizes, positions and techniques. They can also use the computer to predict exactly how blood will flow around the new valve in the beating heart.

These computer simulations can make valve procedures safer and more predictable. They can help patients and doctors decide which is the best procedure for them. They can help doctors learn about new catheter-based techniques more quickly and more safely. The computer simulations can also help patients avoid long stays in hospital and reduce the surgery costs to the health system.

NSW was one of the first places in the world to introduce catheter based mitral valve replacement, and NSW continues to lead the way coordinating the largest trials in this new procedure. This project will reinforce the leading role of NSW in health research in this area. It will also give NSW patients access to the very best possible technology for planning and performing their heart procedures.