Planning saves babies

Dr. Y and his teams expanded cardiovascular knowledge beyond valves with years of flow and physiology data gathered with ultrasound and magnetic resonance imaging, modeling, and computer simulation. This led to the breakthrough that pediatric surgeon del Nido values most: planning software for difficult cardiac surgeries in babies with deadly birth defects.

Though Dr. Y started pediatric surgery planning nearly 20 years after first opening his lab, he faced that familiar trial-and-error dilemma in surgeons’ struggles to save babies’ lives. “Surgeons would try something. If it worked, they kept doing it,” del Nido said. “A lot of it was apprenticeship. ‘My mentor did it this way, so I do it this way, too.’

“Dr. Y pointed out ways to predict what surgery would do to blood flow. It meant we no longer had to do experimentation on children. It seems like an obvious concept, but it was a profound change in the field.”

Pediatric patients are chronically underserved in medical research. Especially with rare disorders, there are so few pediatric patients that developing new solutions can’t be financed. Yoganathan seized the opportunity for sweeping change, at a low cost, in a particularly vexing heart defect.

“Roughly two in every 1,000 children born in the U.S. only have half a heart, only one ventricle that is functioning,” Yoganathan said. “I got the idea of making the surgeries for it more systematic by using surgical planning in a simulation.”

“Now we can get patient-specific surgical solutions based on the anatomy and physiology of the individual,” said Kirk Kanter, a professor of cardiothoracic surgery at Emory University School of Medicine and a collaborator with Dr. Y on surgical planning. “We experiment with five or six surgeries on the computer to come up with optimal choices.”

“There were others who dabbled at this, but no one with Dr. Y’s level of knowledge who could combine it with the resources he had at Georgia Tech, like in mechanical engineering or computer engineering. It was seamless for him but would have presented hurdles at many other institutions,” del Nido said.

For the software’s development, Dr. Y tapped into the expertise of Jarek Rossignac, a professor in Georgia Tech’s College of Computing. Yoganathan also leveraged collaborations with Children’s Hospital of Philadelphia and Children’s Healthcare of Atlanta, clinical relationships that continue to benefit Georgia Tech.