Hemodynamics of patient-specific aorta-pulmonary shunt configurations

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Presentation transcript:

Hemodynamics of patient-specific aorta-pulmonary shunt configurations Senol Piskin, H. Firat Altin, Okan Yildiz, Ihsan Bakir, Kerem Pekkan Journal of Biomechanics Volume 50, Pages 166-171 (January 2017) DOI: 10.1016/j.jbiomech.2016.11.014 Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 1 Three-dimensional reconstructions of the neonatal great arteries and 4 different shunt configurations for the pulmonary artery atresia patient. (LEFT, sagittal plane). Only the largest (5mm) diameter shunt is displayed, but other sizes studied (3.5 and 4mm) are provided in scale for comparison. The colored rapid prototypes, shown on RIGHT, are obtained using ProJet 260C 3D (3D Systems, USA), employed for feasibility and risk assessment during pre-surgical planning. Description of the shunt types are as follows; Right mBT innominate (in) configuration connects innominate artery (IA) to right pulmonary artery (RPA). The central shunt is placed between the proximal ascending aorta (Aao) and the main pulmonary artery (MPA). A right modified Blalock-Taussig (mBT) subclavian (sc) shunt connects the right subclavian artery (RSA) to RPA. Finally the left mBT subclavian shunt connects the left subclavian artery (LSA) blood to the left pulmonary artery (LPA). Section A-A indicates aortic isthmus where the mesh convergence of the velocity profile is conducted (Supplementary material, Figure A). Sections B-B and C-C indicate the cross sections where the vortex formation activity are visualized in Figs. 2–5. Dao: Descending aorta, RCA: Right carotid artery, LCA: Left carotid artery. Journal of Biomechanics 2017 50, 166-171DOI: (10.1016/j.jbiomech.2016.11.014) Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 2 3D blood flow streamlines plotted for the 3.5mm right modified Blalock Taussig (mBT) subclavian shunt configuration. Major vortex formations stabilized at left pulmonary artery (LPA) and right pulmonary artery (RPA) are observed. Corresponding planar velocity vector plots along typical LPA and RPA vessel cross-sections are shown on the RIGHT. Close-up of the wall shear stress (WSS) distribution on the shunt surface and at the anastomosis proximity are also shown. Dao: Descending aorta, RSA: Right subclavian artery, LSA: Left subclavian artery, LCA: Left carotid artery. The upper scale on the color key indicates velocity in cm/s, the lower scale indicates pressure in Pascals. Journal of Biomechanics 2017 50, 166-171DOI: (10.1016/j.jbiomech.2016.11.014) Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 3 3D blood flow streamlines plotted for the 3.5mm right modified Blalock Taussig (mBT) innominate shunt configuration. Major vortex formations stabilized at left pulmonary artery (LPA) and right pulmonary artery (RPA) are observed. Corresponding planar velocity vector plots along typical LPA and RPA vessel cross-sections are shown on the RIGHT. Close-ups of the wall shear stress (WSS) distribution on the shunt surface and at the anastomosis proximity are also shown. Journal of Biomechanics 2017 50, 166-171DOI: (10.1016/j.jbiomech.2016.11.014) Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 4 3D blood flow streamlines plotted for the 5mm central shunt configuration. Major vortex formations stabilized at left pulmonary artery (LPA) and right pulmonary artery (RPA) are observed. Corresponding planar velocity vector plots along typical LPA and RPA vessel cross-sections are shown on the RIGHT. Close-ups of the wall shear stress (WSS) distribution on the shunt surface and at the anastomosis proximity are also shown. Journal of Biomechanics 2017 50, 166-171DOI: (10.1016/j.jbiomech.2016.11.014) Copyright © 2016 Elsevier Ltd Terms and Conditions

Fig. 5 3D blood flow streamlines plotted for the 5mm left modified Blalock Taussig (mBT) subclavian shunt configuration. Major vortex formations stabilized at left pulmonary artery (LPA) and right pulmonary artery (RPA) are observed. Corresponding planar velocity vector plots along typical LPA and RPA vessel cross-sections are shown on the RIGHT. Close-ups of the wall shear stress (WSS) distribution on the shunt surface and at the anastomosis proximity are also shown. Journal of Biomechanics 2017 50, 166-171DOI: (10.1016/j.jbiomech.2016.11.014) Copyright © 2016 Elsevier Ltd Terms and Conditions