The Harry S. Moss Heart Trust has funded the Oden Institute’s work to create patient-specific mitral valve models to improve treatment of this form of heart disease.
“It is widely believed that to achieve better patient outcomes, treatment of the mitral valve needs to be tailored to each patient’s specific condition,” says Oden Institute Professor Michael Sacks. “The Moss Foundation’s one-year grant will help to exploit our pre-surgical imaging based state-of-the-art mitral valve computational models to develop optimized patient specific procedures for the treatment of mitral valve disease. Such approaches can eliminate trial-and-error methods and lead the way for improved quality of care.”
Diseases of the mitral heart valve affect at least 300,000 Americans annually, and this important clinical problem is expected to grow substantially during the next 20 years as the population ages. However, there is no consensus regarding the best surgical procedure. Moreover, recent development of minimally invasive approaches have shown promise, yet many questions as to the optimal use and longevity of such approaches remain unanswered.
Multi-center registries and randomized trials would be necessary to prove which procedure is superior. Given the complexity and duration of such studies, it is highly unlikely that surgical procedure optimization will be achieved by prospective clinical trials alone. It is widely believed that to achieve better patient outcomes, treatment of the mitral valve needs to be tailored to each patient’s specific condition. One reason for this is that currently surgeons have no way of accounting for the natural variations in the structure and diseased state of the mitral valve for each patient.
“We have recently developed a completely non-invasive method to develop patient-specific models of the mitral for post-surgical state, built from strictly pre-surgical clinical imaging data,” says Sacks, who directs the Oden Institute’s Willerson Center for Cardiovascular Modeling and Simulation and is a professor in the Department of Biomedical Engineering.
To help improve surgical outcomes, the computational modeling technique will take the geometric data from pre-surgical clinically obtained images of the mitral valve, and develop a patient specific mitral valve model. The model can then simulate the structure of the valve and demonstrate how it closes in its pre-surgical state. From there the model can simulate different surgical scenarios in-silico, the results of which can be used to choose the scenario that predicts the best clinical outcome.
“So far the model has shown high predictive power,” says Sacks. “Before being used clinically, we need to show that surgeons can obtain better results using the model than without it. Also, the custom model software will have to be streamlined so it can perform computations at a speed suitable for clinical decisions.”
For optimization, Sack’s group will be working with Dr. Michael Jessen of UT Southwestern Medical Center, and Dr. Michael Pirwitz of UT Austin’s Dell Medical School, along with Drs. Robert and Joseph Gorman of the University of Pennsylvania to further refine the modeling approach retrospectively on clinical imaging data.
The Harry S. Moss Heart Trust was established to support organizations working to prevent and cure heart disease after the 1970 death of the Dallas philanthropist, oilman, and civic leader. His wife, Florence Moss, who died in 1978, added a substantial portion of her estate to the Trust.