GoKawiilOne morning in May 2019, a cardiac surgeon stepped into the operating room at Boston Children’s Hospital more prepared than ever before to perform a high-risk procedure to rebuild a child’s heart. The surgeon was experienced, but he had an additional advantage: He had already performed the procedure on this child dozens of times—virtually. He knew exactly what to do before the first cut was made. Even more important, he knew which strategies would provide the best possible outcome for the child whose life was in his hands.
How was this possible? Over the prior weeks, the hospital’s surgical and cardio-engineering teams had come together to build a fully functioning model of the child’s heart and surrounding vascular system from MRI and CT scans. They began by carefully converting the medical imaging into a 3D model, then used physics to bring the 3D heart to life, creating a dynamic digital replica of the patient’s physiology. The mock-up reproduced this particular heart’s unique behavior, including details of blood flow, pressure differentials, and muscle-tissue stresses.
This type of model, known as a virtual twin, can do more than identify medical problems—it can provide detailed diagnostic insights. In Boston, the team used the model to predict how the child’s heart would respond to any cut or stitch, allowing the surgeon to test many strategies to find the best one for this patient’s exact anatomy.
That day, the stakes were high. With the patient’s unique condition—a heart defect in which large holes between the atria and ventricles were causing blood to flow between all four chambers—there was no manual or textbook to fully guide the doctors. The condition strains the lungs, so the doctors planned an open-heart surgery to reroute deoxygenated blood from the lower body directly to the lungs, bypassing the heart. Typically with this kind of surgery, decisions would be made on the fly, under demanding conditions, and with high uncertainty. But in this case, the plan had been tested in advance, and the entire team had rehearsed it before the first incision. The surgery was a complete success.
Such procedures have become routine at the Boston hospital. Since that first patient, nearly 2,000 procedures have been guided by virtual-twin modeling. This is the power of the technology behind the Living Heart Project, which I launched in 2014, five years before that first procedure. The project started as an exploratory initiative to see if modeling the human heart was possible. Now with more than 150 member organizations across 28 countries, the project includes dozens of multidisciplinary teams that regularly use multiscale virtual twins of the heart and other vital organs.
This technology is reshaping how we understand and treat the human body. To reach this transformative moment, we had to solve a fundamental challenge: building a digital heart accurate enough—and trustworthy enough—to guide real clinical decisions.
A father’s concern
Now entering its second decade, the Living Heart Project was born in part from a personal conviction. For many years, I had watched helplessly as my daughter Jesse faced endless diagnostic uncertainty due to a rare congenital heart condition in which the position of the ventricles is reversed, threatening her life as she grew. As an engineer, I understood that the heart was an array of pumping chambers, controlled by an electrical signal and its blood flow carefully regulated by valves. Yet I struggled to grasp the unique structure and behavior of my daughter’s heart well enough to contribute meaningfully to her care. Her specialists knew the bleak forecast children like her faced if left untreated, but because every heart with her condition is anatomically unique, they had little more than their best guesses to guide their decisions about what to do and when to do it. With each specialist, a new guess.
Then my engineering curiosity sparked a question that has guided my career ever since: Why can’t we simulate the human body the way we simulate a car or a plane?
At a visualization center in Boston, VR imagery helps the mother of a young girl with a complex heart defect understand the inner workings of her child’s heart. Dassault Systèmes
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