{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:40:50Z","timestamp":1755794450228,"version":"3.43.0"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Congenital heart disease (CHD) is the most common birth defect and the leading cause of infant death from congenital anomalies. Limitations in standard\u2010of\u2010care fetal echocardiography lack hemodynamic insight. Cardiovascular computational\u00a0modeling methods have been developed to simulate patient\u2010specific morphology and hemodynamics, but are limited in applications for fetal diagnosis, as existing pipelines depend upon 3D CMR imaging data. There is no existing workflow for converting 2D echocardiograms into models of the fetal aorta. We aim to develop a methodology to create pulsatile 3D\u2010aortic models from standard\u2010of\u2010care 2D echocardiograms to supplement fetal imaging with noninvasive predictions of hemodynamics in CHD diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Utilizing 2D fetal echocardiograms, edge detection algorithms are applied to delineate vessel boundaries. Cross\u2010sectional diameters along the aortic arch and branch centerlines were segmented, integrated into 3D geometric models, and reconstructed using SimVascular. Patient\u2010specific simulations were developed for three false\u2010positive coarctation of the aorta (CoA) fetuses and 3 true positive CoA fetuses (postnatally confirmed), using echocardiogram and Doppler source data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We propose a modeling methodology and set of boundary conditions that generate physiologically reasonable and cross\u2010validated quantifications of fetal hemodynamics. Noninvasive predictions of fetal aortic pressures, flow streamlines, and vessel displacement offer insight into real\u2010time hemodynamics and the stress of abnormal morphology on flow directions in the prenatal aorta.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We present a clinically useful pipeline for generating simulations of flow in the fetal aorta that capture fluid\u2013structure interactions and generate noninvasive predictions of diagnostic hemodynamic indicators that could not previously be captured prenatally. This pipeline integrates into clinical diagnosis and offers insight into patient\u2010specific physiology beyond a visualization of cardiac morphology alone, offering the potential to enhance the diagnostic precision of CHDs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16721","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T09:55:35Z","timestamp":1748426135000},"page":"1657-1679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Novel Prenatal Pipeline for Three\u2010Dimensional Hemodynamic Modeling of the Fetal Aorta"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8628-6487","authenticated-orcid":false,"given":"Joanne","family":"Sarsam","sequence":"first","affiliation":[{"name":"Department of Computational and Systems Biology UCLA  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4132-9140","authenticated-orcid":false,"given":"Angela","family":"Desmond","sequence":"additional","affiliation":[{"name":"Division of Neonatal\u2010Perinatal Medicine, Department of Pediatrics UCLA  Los Angeles California USA"},{"name":"David Geffen School of Medicine UCLA  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehrdad","family":"Roustaei","sequence":"additional","affiliation":[{"name":"Department of Bioengineering UCLA Samueli School of Engineering  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Satou","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine UCLA  Los Angeles California USA"},{"name":"Division of Cardiology, Department of Pediatrics UCLA  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3807-7022","authenticated-orcid":false,"given":"Yalda","family":"Afshar","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology UCLA  Los Angeles California USA"},{"name":"Molecular Biology Institute UCLA  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.5935\/abc.20180175"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2710"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2007.119032"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14882"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.053062"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.7.889"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3783"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00087"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2024.1288339"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcp.2015.11.022"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/wsbm.1608"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.11.068"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd12020070"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd10060240"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.13644"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4004996"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-020-02683-x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00235.2018"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0045-7825(82)90128-1"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cma.2005.11.01"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198712000-00004"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.03.084"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.11.015"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-016-1762-8"},{"key":"e_1_2_8_26_1","unstructured":"PlotDigitizer.Version 3.1.5.2024.https:\/\/plotdigitizer.com."},{"volume-title":"Cardiovascular Biomechanics","year":"2018","author":"Hellevik LR","key":"e_1_2_8_27_1"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12576-017-0585-1"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2017.06.005"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6137"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnm.2598"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00037.2009"},{"key":"e_1_2_8_33_1","first-page":"717","volume-title":"Visualization Handbook","author":"Johnson CR","year":"2005"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcdd11040113"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aanat.2006.06.008"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00078.x"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2004.04.011"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.3538"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030640"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1542\/neo.19-3-e134"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21957"},{"key":"e_1_2_8_42_1","first-page":"230","article-title":"Difficult prenatal diagnosis: fetal coarctation","volume":"4","author":"Buyens A","year":"2012","journal-title":"Facts Views Vis Obgyn"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.08.056"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.121.012411"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2000.897928"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4753"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.84.1.59"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1990.69.1.112"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.04.021"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.21037\/cdt-20-770"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000157151.10971.98"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-021-02841-9"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.16721","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T12:14:14Z","timestamp":1754482454000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.16721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":51,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/jum.16721"],"URL":"https:\/\/doi.org\/10.1002\/jum.16721","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"type":"print","value":"0278-4297"},{"type":"electronic","value":"1550-9613"}],"subject":[],"published":{"date-parts":[[2025,5,28]]},"assertion":[{"value":"2024-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}