Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclu...Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclusion on surgical plan chosen for the particular patient. Methods Shunt configurations including central shunt(CS) and MBTS(Right mb T innominate;Left m BT subclavian) were virtually reconstructed for newborn based on preoperative CT data. Candidate shunt configurations were evaluated based on the parameters that were computed from the flow simulations. Results Vortex occurred at the anastomosis of the shunt and the aorta for all three shunt configurations. For CS, it produced the highest pulmonary artery(PA) flow, with the shunt ratio of44.6%. Blood flow in LPA was 8.5% higher than blood flow in RPA. For MBTS, the indexed power loss(i PL)of Right m BT innominate configuration was lower than that of Left m BT subclavian, which was 28.4% and 36.1%respectively. Conclusions The anastomosis of the shunt and the aorta is prone to cause thrombosis. CS configuration is prone to cause hyperemia due to excessive pulmonary blood flow. So, it could be considered for patients without a risk of overflow. It also causes non-symmetric PA flow in favor of LPA. For Right m BT innominate,which has the lowest i PL, tends to produce smaller vortex regions compared to CS and Left m BT subclavian. As for Left m BT subclavian, vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.[S Chin J Cardiol 2019;20(4):217-227]展开更多
基金funded by the key Program of Union of National Natural Science Foundation of China-Guangdong Province(No.U1401255)the Natural Science Foundation of Guangdong Province(No.2018A030313785)+2 种基金the National key Research and Development Program(No.2018YFC1002600)the Science and Technology Planning Project of Guangdong Province(No.2019B020230003/No.2018B090944002/No.2017A070701013/No.2017B090904034/No.2017B030314109)Guangdong Medical Science and Technology Research Fund(No.A2018038)
文摘Background Systemic-to-pulmonary shunt(SPS) is an effective surgery for newborns diagnosed with atresia or severe pulmonary stenosis leading to insufficient pulmonary blood flow. However, there is no consistent conclusion on surgical plan chosen for the particular patient. Methods Shunt configurations including central shunt(CS) and MBTS(Right mb T innominate;Left m BT subclavian) were virtually reconstructed for newborn based on preoperative CT data. Candidate shunt configurations were evaluated based on the parameters that were computed from the flow simulations. Results Vortex occurred at the anastomosis of the shunt and the aorta for all three shunt configurations. For CS, it produced the highest pulmonary artery(PA) flow, with the shunt ratio of44.6%. Blood flow in LPA was 8.5% higher than blood flow in RPA. For MBTS, the indexed power loss(i PL)of Right m BT innominate configuration was lower than that of Left m BT subclavian, which was 28.4% and 36.1%respectively. Conclusions The anastomosis of the shunt and the aorta is prone to cause thrombosis. CS configuration is prone to cause hyperemia due to excessive pulmonary blood flow. So, it could be considered for patients without a risk of overflow. It also causes non-symmetric PA flow in favor of LPA. For Right m BT innominate,which has the lowest i PL, tends to produce smaller vortex regions compared to CS and Left m BT subclavian. As for Left m BT subclavian, vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.[S Chin J Cardiol 2019;20(4):217-227]
