TY - JOUR
T1 - Tailoring the hybrid palliation for hypoplastic left heart syndrome
T2 - A simulation study using a lumped parameter model
AU - Di Molfetta, A.
AU - Pilati, M.
AU - Gagliardi, M. G.
AU - Fresiello, L.
AU - Amodeo, A.
AU - Cristofaletti, A.
AU - Pongiglione, G.
AU - Ferrari, G.
N1 - Publisher Copyright:
© 2015 IPEM.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - The results of Hybrid procedure (HP) for the hypoplastic left heart syndrome (HLHS) depend on several variables: pulmonary artery banding tightness (PAB), atrial septal defect size (ASD) and patent ductus arteriosus stent size (PDA). A HP complication could be the aortic coarctaction (CoAo). The reverse Blalock-Taussig shunt (RevBT) placement was proposed to avoid CoAo effects. This work aims at developing a lumped parameter model (LPM) to investigate the effects of the different variables on HP haemodynamics. A preliminary verification was performed collecting measurements on a newborn HLHS patient to calculate LPM input parameters to reproduce patient's baseline. Results suggest that haemodynamics is affected by ASD (ASD: 0.15-0.55 cm, pulmonary to systemic flow ratio Q p/Q s: 0.73-1, cardiac output (CO): 1-1.5 l/min and ventricular stroke work SW: 336-577 ml mmHg) and by the PAB diameter (PAB: 0.07-0.2 cm, Q p/Q s: 0.46-2.1, CO: 1.3-1.6 l/min and SW: 591-535 ml mmHg). Haemodynamics was neither affected by RevBT diameter nor by PDA diameter higher than 0.2 cm. RevBT implantation does not change the HP haemodynamics, but it can make the CoAo effect negligible. LPM could be useful to support clinical decision in complex physiopathology and to calibrate and personalise the parameters that play a role on flow distribution.
AB - The results of Hybrid procedure (HP) for the hypoplastic left heart syndrome (HLHS) depend on several variables: pulmonary artery banding tightness (PAB), atrial septal defect size (ASD) and patent ductus arteriosus stent size (PDA). A HP complication could be the aortic coarctaction (CoAo). The reverse Blalock-Taussig shunt (RevBT) placement was proposed to avoid CoAo effects. This work aims at developing a lumped parameter model (LPM) to investigate the effects of the different variables on HP haemodynamics. A preliminary verification was performed collecting measurements on a newborn HLHS patient to calculate LPM input parameters to reproduce patient's baseline. Results suggest that haemodynamics is affected by ASD (ASD: 0.15-0.55 cm, pulmonary to systemic flow ratio Q p/Q s: 0.73-1, cardiac output (CO): 1-1.5 l/min and ventricular stroke work SW: 336-577 ml mmHg) and by the PAB diameter (PAB: 0.07-0.2 cm, Q p/Q s: 0.46-2.1, CO: 1.3-1.6 l/min and SW: 591-535 ml mmHg). Haemodynamics was neither affected by RevBT diameter nor by PDA diameter higher than 0.2 cm. RevBT implantation does not change the HP haemodynamics, but it can make the CoAo effect negligible. LPM could be useful to support clinical decision in complex physiopathology and to calibrate and personalise the parameters that play a role on flow distribution.
KW - Congenital heart defects
KW - Hypoplastic left heart syndrome
KW - Lumped parameter models
UR - http://www.scopus.com/inward/record.url?scp=84940447145&partnerID=8YFLogxK
U2 - 10.1016/j.medengphy.2015.04.012
DO - 10.1016/j.medengphy.2015.04.012
M3 - Article
C2 - 26215925
AN - SCOPUS:84940447145
SN - 1350-4533
VL - 37
SP - 898
EP - 904
JO - Medical Engineering and Physics
JF - Medical Engineering and Physics
IS - 9
ER -
