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Effect of modified Blalock-Taussig shunt anastomosis angle and pulmonary artery diameter on pulmonary flow [Anatol J Cardiol]
Anatol J Cardiol. 2018; 20(1): 2-8 | DOI: 10.14744/AnatolJCardiol.2018.54810  

Effect of modified Blalock-Taussig shunt anastomosis angle and pulmonary artery diameter on pulmonary flow

Ahmet Arnaz1, Şenol Pişkin3, Gökçe Nur Oğuz2, Yusuf Yalçınbaş4, Kerem Pekkan2, Tayyar Sarıoğlu1
1Department of Cardiovascular Surgery, Faculty of Medicine, Acıbadem Mehmet Ali Aydınlar University; İstanbul-Turkey
2Department of Mechanical Engineering, Koç University; İstanbul-Turkey
3Department of Mechanical Engineering, Koç University; İstanbul-Turkey; Department of Mechanical Engineering, University of Texas at San Antonio; San Antonio, TX-USA
4Department of Cardiovascular Surgery, Acıbadem Bakırköy Hospital; İstanbul-Turkey

Objective: This study aimed to identify the best graft-to-pulmonary artery (PA) anastomosis angle measuring pulmonary blood flow, wall shear stress (WSS), and shunt flow.
Methods: A tetralogy of Fallot with pulmonary atresia computer model was used to study three different modified Blalock-Taussig shunt (mBTS) anastomosis angle configurations with three different PA diameter configurations. Velocity and WSS were analyzed, and the flow rates at the right PA (RPA) and left PA (LPA) were calculated.
Results: A 4-mm and 8-mm diameter of RPA and LPA, respectively with vertical shunt angle produces the highest total flow. In the RPA larger diameter than the LPA configutations, the left-leaning shunt produces the lowest total PA flow whereas in the LPA larger diameter than the RPA configuratios, the right-leaning shunt produces the lowest total PA flow. Therefore, the shunt anastomosis should not be leaned through the narrow side of PA to reach best flow. As the flow inside the shunt increased, WSS also increased due to enhanced velocity gradients.
Conclusion: The anastomosis angle between the conduit and PA affects the flow to PA. Vertical anastomosis configurations increase the total PA flow; thus, these configurations are preferable than the leaned configurations.

Keywords: modified Blalock-Taussig shunt, shunt stenosis, computational fluid dynamics, hemodynamic, simulations


Ahmet Arnaz, Şenol Pişkin, Gökçe Nur Oğuz, Yusuf Yalçınbaş, Kerem Pekkan, Tayyar Sarıoğlu. Effect of modified Blalock-Taussig shunt anastomosis angle and pulmonary artery diameter on pulmonary flow. Anatol J Cardiol. 2018; 20(1): 2-8

Corresponding Author: Ahmet Arnaz, Türkiye


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