Biomechanics in congenital heart disease: Using advanced imaging techniques

This thesis aims to answer questions on the pathophysiology in congenital heart disease focusing on personalized biomechanical and geometric risk factors. Using detailed advanced non-invasive imaging techniques and state-of-the-art techniques, personalized and local data were extracted from imaging techniques (mainly cardiovascular magnetic resonance (CMR)) and studied for its pathophysiological role in congenital heart disease. The first part of this thesis focused on accurate assessment of valvular flow. The next part describes the role of wall shear stress in aortic disease in patients with a bicuspid aortic valve using 4D flow CMR. In the third part, long-term outcomes and the influence of aortic geometry in patients with an aortic coarctation are described. In the final part, we developed a method to calculate wall stress in the free wall of the right ventricle in Tetralogy of Fallot patients and associated serial wall stress measurements with right ventricular function.