Effects of patent ductus arteriosus on the hemodynamics of modified Blalock–Taussig shunt based on patient-specific simulation

Jiwen Xiong, Qi Sun*, Yi Qian, Liwei Hu, Zhirong Tong, Jinfen Liu, Jinlong Liu

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    3 Citations (Scopus)
    32 Downloads (Pure)

    Abstract

    The question of preserving the patent ductus arteriosus (PDA) during the modified Blalock–Taussig shunt (MBTS) procedure remains controversial. The goal of this study was to investigate the effects of the PDA on the flow features of the MBTS to help with preoperative surgery design and postoperative prediction. In this study, a patient with pulmonary atresia and PDA was included. A patient-specific three-dimensional model was reconstructed, and virtual surgeries of shunt insertion and ductus ligation were performed using computer-aided design. Computational fluid dynamics was utilized to analyze the hemodynamic parameters of varied models based on the patient-specific anatomy and physiological data. The preservation of the PDA competitively reduced the shunt flow but increased total pulmonary perfusion. The shunt flow and ductal flow collided, causing significant and complicated turbulence in the pulmonary artery where low wall shear stress, high oscillatory shear index, and high relative residence time were distributed. The highest energy loss was found when the PDA was preserved. The preservation of PDA is not recommended during MBTS procedures because it negatively influences hemodynamics. This may lead to pulmonary overperfusion, inadequate systemic perfusion, and a heavier cardiac burden, thus increasing the risk of heart failure. Also, it seems to bring no benefit in terms of reducing the risk for thrombosis.

    Original languageEnglish
    Article number707128
    Pages (from-to)1-10
    Number of pages10
    JournalFrontiers in Physiology
    Volume12
    DOIs
    Publication statusPublished - 31 Aug 2021

    Bibliographical note

    Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

    Keywords

    • computational fluid dynamics
    • hemodynamics
    • modified Blalock-Taussig shunt
    • patent ductus arteriosus
    • virtual surgery

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