Tiny hearts in big trouble: cardiac flow hydrodynamics in fetal single ventricle hearts

The fetal circulatory system is flexible and rapidly adaptive, undergoing extreme remodeling over the second and third trimesters. In order to monitor circulatory development, clinicians rely on fetal echocardiogram exams. However, exams focus mainly on tissue morphology, employing Doppler scans to look for other abnormalities such as valve disease and atrio-ventricular shunting. The study of human fetal cardiac hemodynamics has recently begun as advances in echocardiography improve spatial and temporal resolution. Still, more complex flow measurements such as vortex formation and intraventricular pressure remain relatively unexplored. This work focuses on human fetal cardiac flow measurements derived from normal and abnormal fetal echocardiogram exams from 20 weeks to 35 weeks (near term) using an in-house 2D color Doppler reconstruction method. We will explore how filling mechanics and flow structure change over the course of gestation and begin to understand how these are altered in the presence of abnormal circulatory systems.