title: Multiscale models of the hybrid palliation for hypoplastic left heart syndrome.
abstract: A less-invasive procedure that combines interventional stent placement in the ductus arteriosus and surgical banding of the branch pulmonary arteries has been recently introduced in the treatment of the hypoplastic left heart syndrome (HLHS). The hemodynamic behaviour of this hybrid approach has not been examined before in a mathematical model. In this study, a mathematical model of the hybrid procedure for HLHS is described, applying a multiscale approach that couples 3D models of the area of the surgical operation and lumped parameter models of the remaining circulation. The effects of various degrees of pulmonary banding and different stent sizes inserted in the ductus arteriosus on pulmonary-systemic flow ratio, cardiac output and oxygen delivery were assessed. Computational results suggest that balanced systemic and pulmonary blood flow and optimal systemic oxygen delivery are sensitive to the degree of pulmonary arterial banding and not to the size of the ductal stent.
authors.affiliation: Laboratory of Biological Structure Mechanics, Structural Engineering Department, Politecnico di Milano, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Corsini
authors.forename: Daria
authors.initials: D
authors.lastname: Cosentino
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pennati
authors.forename: Gabriele
authors.initials: G
authors.lastname: Dubini
authors.forename: Tain-Yen
authors.initials: TY
authors.lastname: Hsia
authors.forename: Francesco
authors.initials: F
authors.lastname: Migliavacca
mesh_terms: D002302:Cardiac Output; D003131:Combined Modality Therapy; D003198:Computer Simulation; D003326:Coronary Circulation; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000503:physiopathology* / Q000601:surgery*; D008955:Models, Cardiovascular; D010100:Oxygen / Q000378:metabolism*; D010166:Palliative Care / Q000379:methods; D011652:Pulmonary Circulation; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
chemical_list: D010100:Oxygen