The Journal of Thoracic and Cardiovascular Surgery
Volume 136, Issue 2 , Pages 312-320.e2 , August 2008

Use of mathematic modeling to compare and predict hemodynamic effects of the modified Blalock–Taussig and right ventricle–pulmonary artery shunts for hypoplastic left heart syndrome

  • Edward L. Bove, MD

      Affiliations

    • Section of Cardiac Surgery, the University of Michigan School of Medicine, Ann Arbor, Mich
    • Corresponding Author InformationAddress for reprints: Edward L. Bove MD, F 7830 Mott Children's Hospital, 1500 East Medical Center Dr, University of Michigan, Ann Arbor, MI 48109-0223.
    • ,
  • Francesco Migliavacca, PhD

      Affiliations

    • Laboratory of Biological Structure Mechanics, Department of Structural Engineering, Politecnico di Milano, Milan, Italy
    • ,
  • Marc R. de Leval, MD

      Affiliations

    • International Congenital Cardiac Center and Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
    • ,
  • Rossella Balossino, PhD

      Affiliations

    • Laboratory of Biological Structure Mechanics, Department of Structural Engineering, Politecnico di Milano, Milan, Italy
    • ,
  • Giancarlo Pennati, PhD

      Affiliations

    • Laboratory of Biological Structure Mechanics, Department of Structural Engineering, Politecnico di Milano, Milan, Italy
    • ,
  • Thomas R. Lloyd, MD

      Affiliations

    • Section of Cardiac Surgery, the University of Michigan School of Medicine, Ann Arbor, Mich
    • ,
  • Sachin Khambadkone, MD

      Affiliations

    • International Congenital Cardiac Center and Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
    • ,
  • Tain-Yen Hsia, MD

      Affiliations

    • International Congenital Cardiac Center and Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
    • ,
  • Gabriele Dubini, PhD

      Affiliations

    • Laboratory of Biological Structure Mechanics, Department of Structural Engineering, Politecnico di Milano, Milan, Italy

Received 1 March 2007 ,Revised 23 March 2007 ,Accepted 9 April 2007.

References 

  1. Norwood WI, Lang P, Castaneda AR, Campbell DN. Experience with operations for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 1981;85:511–519
  2. Imoto Y, Kado H, Shiokawa Y, Minami K, Yasui H. Experience with the Norwood procedure without circulatory arrest. J Thorac Cardiovasc Surg. 2001;122:879–882
  3. Sano S, Ishino K, Kawada M, Arai S, Kasahara S, Asai T, et al. Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2003;126:504–509
  4. Maher KO, Pizarro C, Gidding SS, Januszewska K, Malec E, Norwood WI, et al. Hemodynamic profile after the Norwood procedure with right ventricle to pulmonary artery conduit. Circulation. 2003;108:782–784
  5. Mair R, Tulzer G, Sames E, Gitter R, Lechner E, Steiner J, et al. Right ventricular to pulmonary artery conduit instead of modified Blalock-Taussig shunt improves postoperative hemodynamics in newborns after the Norwood operation. J Thorac Cardiovasc Surg. 2003;126:1378–1384
  6. Malec E, Januszewska K, Kolcz J, Mroczek T. Right ventricle-to-pulmonary artery shunt versus modified Blalock-Taussig shunt in the Norwood procedure for hypoplastic left heart syndrome—influence on early and late hemodynamic status. Eur J Cardiothorac Surg. 2003;23:728–733
  7. Pizarro C, Norwood WI. Right ventricle to pulmonary artery conduit has a favorable impact on postoperative physiology after stage I Norwood: preliminary results. Eur J Cardiothorac Surg. 2003;23:991–995
  8. Januszewska K, Kolcz J, Mroczek T, Procelewska M, Malec E. Right ventricle-to-pulmonary artery shunt and modified Blalock-Taussig shunt in preparation to hemi-Fontan procedure in children with hypoplastic left heart syndrome. Eur J Cardiothorac Surg. 2005;27:956–961
  9. Ghanayem NS, Jaquiss RD, Cava JR, Frommelt PC, Mussatto KA, Hoffman GM, et al. Right ventricle-to-pulmonary artery conduit versus Blalock-Taussig shunt: a hemodynamic comparison. Ann Thorac Surg. 2006;82:1603–1609
  10. Laganà K, Balossino R, Migliavacca R, Pennati G, Bove EL, de Leval MR, et al. Multiscale modeling of the cardiovascular system: Application to the study of pulmonary and coronary perfusions in the univentricular circulation. J Biomech. 2005;38:1129–1141
  11. Migliavacca F, Yates R, Pennati G, Dubini G, Fumero R, de Leval MR. Calculating blood flow from Doppler measurements in the systemic-to-pulmonary artery shunt after the Norwood operation: a method based on computational fluid dynamics. Ultrasound Med Biol. 2000;26:209–219
  12. Migliavacca F, Balossino R, Pennati G, Dubini G, Hsia T-Y, de Leval MR, et al. Multiscale modelling in biofluidynamics: application to reconstructive pediatric cardiac surgery. J Biomech. 2006;26:1010–1020
  13. Pennati G, Bellotti M, Fumero R. Mathematical modeling of the human fetal cardiovascular system based on Doppler ultrasound data. Med Eng Phys. 1997;19:327–335
  14. Pennati G, Migliavacca F, Dubini G, Pietrabissa R, de Leval MR. A mathematical model of circulation in the presence of the bidirectional cavopulmonary anastomosis in children with a univentricular heart. Med Eng Phys. 1997;19:223–234
  15. Bove EL, de Leval MR, Migliavacca F, Gaudagni G, Dubini G. Computational fluid dynamics in the evaluation of hemodynamic performance of cavopulmonary connections after the Norwood procedure for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2003;126:1040–1047
  16. Migliavacca F, Pennati G, Dubini G, Fumero R, Pietrabissa R, Urcelay G, et al. Modeling of the Norwood circulation: effects of shunt size, vascular resistances, and heart rate. Am J Physiol Heart Circ Physiol. 2001;280:H2076–H2086
  17. Mantero S, Pietrabissa R, Fumero R. The coronary bed and its role in the cardiovascular system: a review and an introductory single-branch model. J Biomed Eng. 1992;14:109–116
  18. Quarteroni A, Veneziani A. Analysis of a geometrical multiscale model based on the coupling of PDE's and ODE's for blood flow simulations. Multiscale Model Simulation. 2003;1:173–195
  19. Ohye RG, Ludomirsky A, Devaney EJ, Bove EL. Comparison of right ventricle to pulmonary artery conduit and modified Blalock-Taussig shunt hemodynamics following the Norwood operation. Ann Thorac Surg. 2004;78:1090–1093
  20. Mendelsohn AM, Bove EL, Lupinetti FM, Crowley DC, Lloyd TR, Beekman RH. Pulmonary artery growth patterns following the bidirectional Glenn procedure. J Thorac Cardiovasc Surg. 1994;107:1284–1290

PII: S0022-5223(08)00843-X

doi: 10.1016/j.jtcvs.2007.04.078

The Journal of Thoracic and Cardiovascular Surgery
Volume 136, Issue 2 , Pages 312-320.e2 , August 2008

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