Candidate's Plans/Training: The candidate plans a career as a patient-oriented researcher leveraging knowledge in fluid dynamics and image processing to further the practice of pediatric cardiology and cardiovascular imaging. My major research interest involves using fluid dynamic analysis in order to better understand the physiology of congenital heart disease, especially single ventricle physiology. Training will include formal imaging and computational fluid dynamics coursework, and closely mentored completion of the research protocol from both experienced clinical and technical mentors. Research: The group of patients with single ventricle physiology has probably seen more advancement in surgical technique and management than any other group of patients with congenital heart disease in the last two decades. However, they remain the most challenging group of patients to manage. The currently accepted technique of managing single ventricle patients generally involves three stages of surgery which culminate in the total cavopulmonary connection (TCPC). Because relatively small energy losses in the TCPC might result in the long-term failure of this physiology, it is becoming increasingly clear that these losses cannot be ignored. To this end, the primary aims of this proposal are: 1) to characterize the power loss of the TCPC of anatomical Fontan reconstructions under both resting and exercise conditions and to determine whether this power loss relates to exercise performance;2) study the differences in the flow fields and power loss of extracardiac and lateral tunnel Fontans to determine if one is energetically more favorable;3) to utilize exercise testing during cardiac magnetic resonance (CMR) using an MRI-compatible exercise bicycle to further our understanding of the Fontan physiology under resting and exercise conditions.
These aims will be studied using a combination of patient data (MRI's and exercise tests) and MRI-derived anatomically correct computer models of blood flow through these patients'TCPC using finite element computational fluid dynamic analysis.
Public Health: The proposed research will add to our knowledge of how to care for patients with complex birth defects involving the heart, specifically patients with a single ventricle. These patients make up a growing population of adults as about 2000 per year are saved and most are surviving into adulthood.
|Whitehead, Kevin K; Harris, Matthew A; Glatz, Andrew C et al. (2015) Status of systemic to pulmonary arterial collateral flow after the fontan procedure. Am J Cardiol 115:1739-45|
|Di Maria, Michael V; Cohen, Meryl S; Harris, Matthew A et al. (2015) Doppler-derived flow pattern in the descending aorta does not predict systemic to pulmonary arterial collateral flow in patients with single ventricle palliation: a cross-sectional study. World J Pediatr Congenit Heart Surg 6:209-14|
|Glatz, Andrew C; Harrison, Neil; Small, Adam J et al. (2015) Factors associated with systemic to pulmonary arterial collateral flow in single ventricle patients with superior cavopulmonary connections. Heart 101:1813-8|
|Khiabani, Reza H; Whitehead, Kevin K; Han, David et al. (2015) Exercise capacity in single-ventricle patients after Fontan correlates with haemodynamic energy loss in TCPC. Heart 101:139-43|
|Avitabile, Catherine M; Goldberg, David J; Zemel, Babette S et al. (2015) Deficits in bone density and structure in children and young adults following Fontan palliation. Bone 77:12-6|
|Avitabile, Catherine M; Leonard, Mary B; Brodsky, Jill L et al. (2015) Usefulness of insulin like growth factor 1 as a marker of heart failure in children and young adults after the Fontan palliation procedure. Am J Cardiol 115:816-20|
|Avitabile, Catherine M; Leonard, Mary B; Zemel, Babette S et al. (2014) Lean mass deficits, vitamin D status and exercise capacity in children and young adults after Fontan palliation. Heart 100:1702-7|
|Tang, Elaine; Restrepo, Maria; Haggerty, Christopher M et al. (2014) Geometric characterization of patient-specific total cavopulmonary connections and its relationship to hemodynamics. JACC Cardiovasc Imaging 7:215-24|
|Downing, Tacy E; Whitehead, Kevin K; Dori, Yoav et al. (2013) Accuracy of conventional oximetry for flow estimation in patients with superior cavopulmonary connection: a comparison with phase-contrast cardiac MRI. Circ Cardiovasc Imaging 6:943-9|
|Schwartz, Matthew C; Rome, Jonathan J; Gillespie, Matthew J et al. (2012) Relation of left ventricular end diastolic pressure to right ventricular end diastolic volume after operative treatment of tetralogy of fallot. Am J Cardiol 109:417-22|
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