By leveraging advanced computational fluid dynamics (CFD) software, Boston Children’s Hospital has transformed preoperative planning and surgical decision-making for congenital heart disease patients, leading to improved outcomes and reduced revision surgeries.

Empowering Surgeons with Precision and Predictability in Heart Surgeries

Enhancing Surgical Precision Through Advanced Modeling

The integration of CFD into pediatric cardiology at Boston Children’s Hospital marks a significant leap forward in understanding the intricate flow dynamics within the hearts of young patients. Historically, surgeons relied heavily on their expertise and intraoperative judgment to correct congenital heart defects. However, this approach often led to unpredictable outcomes, sometimes necessitating multiple revisions due to suboptimal patch placements or unforeseen complications.Today, the hospital’s cardiology team employs sophisticated CFD simulations to meticulously analyze and predict the effects of various surgical interventions. This shift from guesswork to data-driven precision ensures that each procedure is optimized for long-term success. Dr. David Hoganson, director of the Computational 3D Visualization Program, highlights a case where his team conducted 80 different flow simulations before finalizing the best approach. Without this rigorous analysis, the initial plan would have been entirely incorrect, leading to additional surgeries.

Building a Specialized Engineering Team for Rapid Response

Recognizing the critical need for timely and accurate modeling, Boston Children’s Hospital assembled a specialized engineering team seven years ago. Initially recruiting experts from diverse backgrounds, including the U.S. Department of Defense, the team now comprises 12 professionals—soon expanding to 14—who are dedicated to performing 3D modeling workflows for patients. The ability to respond swiftly to urgent cases has proven transformational. Whether time allows for extensive deliberation or requires immediate action, the team’s agility ensures that solutions are delivered precisely when needed. This capability is crucial in pediatric cardiology, where the urgency of treatment can vary dramatically from patient to patient. Dr. Hoganson emphasizes the importance of not just the technical accuracy but also the timely delivery of these models, ensuring they reach clinicians and families at the most critical moments.

Engaging Families with Transparent Communication

One of the most impactful aspects of incorporating CFD into pediatric cardiac care is the transparency it offers to families. Instead of relying solely on doctors’ explanations, parents and patients can now visualize the proposed surgical plans through detailed 3D models and flow simulation data. This visual representation fosters a deeper understanding and trust in the chosen course of action.Dr. Hoganson notes that while complex scientific principles underpin CFD, it is the tangible, three-dimensional images that resonate most with clinical families. Teenage patients, in particular, have expressed confidence in the proposed procedures, affirming that the recommended approach is clearly the best option. By involving families in the decision-making process, the hospital ensures that everyone feels informed and reassured about the path forward.

Advancing Standards and Advocating for Payer Support

As the use of CFD in pediatric cardiology continues to evolve, Boston Children’s Hospital is actively collaborating with other heart centers and regulatory bodies like the FDA to standardize modeling workflows. This initiative aims to establish consistent practices across institutions, enhancing the reliability and applicability of CFD in treating congenital heart defects.Moreover, the hospital is advocating for payer support by pursuing the creation of specific billing codes for CFD-related services. Working alongside organizations such as the Society of Thoracic Surgeons, the team is striving to gain national recognition for these innovative efforts. While challenges remain, particularly in addressing complex arterial circulation cases, the ongoing refinement of software and workflows promises to expand the utility of CFD in more patient scenarios.

Pioneering Applications Beyond Cardiology

The potential of CFD extends far beyond pediatric heart surgeries. Its applications in respiratory medicine, medical device development, pharmaceutical research, and even air quality systems underscore its versatility. By combining CFD with artificial intelligence, the technology can analyze vast datasets to develop advanced diagnostics and treatments.Dr. Hoganson envisions a future where CFD becomes an integral part of various medical practices, driving improvements in patient care and operational efficiency. Although some limitations still exist, particularly in handling highly complex cases, the continuous advancements in CFD technology hold great promise for transforming healthcare across multiple disciplines.