The haemodynamic 3D simulation analysis of systemic-to-pulmonary shunts in infants with pulmonary stenosis
LIU Jia-wei
YUAN Hai-yun1
ZHANG Nei-chuan2
CHEN Xiang-yu2
JIAN Qi-fei2
HUANG Mei-ping3
1.Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 5100802.School of Mechanical and Automotive Engineering, South China University of Technology, Guangzhou 510641, Guangdong3.Department of Catheterization Lab, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China structural Heart Disease, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
摘要：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 mbT innominate;Left mBT 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 of 44,.6％.Blood flow in LPA was 8.5％ higher than blood flow in RPA.For MBTS,the indexed power loss (iPL)of Right mBT innominate configuration was lower than that of Left mBT 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 mBT innominate,which has the lowest iPL,tends to produce smaller vortex regions compared to CS and Left mBT subclavian.As for Left mBT subclavian,vortex currents formed when blood flows into the LPA could prevent the formation of thrombosis.
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论文发表日期：2019-12-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 217-227,235 )
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