Patient-Specific Multiscale Computational Fluid Dynamics Assessment Of Embolization Rates In The Hybrid Norwood: Effects Of Size And Placement Of The Reverse Blalock–Taussig Shunt

Keywords

Computational fluid dynamics; Hybrid Norwood; Hypoplastic left heart syndrome; Lumped parameter model; Patient specific; Reverse Blalock–Taussig shunt; Thrombus

Abstract

The hybrid Norwood operation is performed to treat hypoplastic left heart syndrome. Distal arch obstruction may compromise flow to the brain. In a variant of this procedure, a synthetic graft (reverse Blalock–Taussig shunt) is placed between the pulmonary trunk and innominate artery to improve upper torso blood flow. Thrombi originating in the graft may embolize to the brain. In this study, we used computational fluid dynamics and particle tracking to investigate the patterns of particle embolization as a function of the anatomic position of the reverse Blalock–Taussig shunt. The degree of distal arch obstruction and position of particle origin influence embolization probabilities to the cerebral arteries. Cerebral embolization probabilities can be reduced by as much as 20% by optimizing graft position, for a given arch geometry, degree of distal arch obstruction, and particle origin. There is a tradeoff, however, between cerebral pulmonary and coronary embolization probabilities.

Publication Date

1-1-2018

Publication Title

Canadian Journal of Physiology and Pharmacology

Volume

96

Issue

7

Number of Pages

690-700

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1139/cjpp-2018-0002

Socpus ID

85049842869 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85049842869

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