Evaluating the efficacy of the punch-out technique in systemic-to-pulmonary shunts: A computational fluid dynamics approach.

IF 1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Bio-medical materials and engineering Pub Date : 2024-01-01 DOI:10.3233/BME-240022
Shiho Yamazaki, Ryosuke Kowatari, Tetsuya Yano, Hanae Sasaki, Kazuyuki Daitoku, Masahito Minakawa
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Abstract

Background: Systemic-to-pulmonary shunt is a palliative procedure used to decrease pulmonary blood flow in congenital heart diseases. Shunt stenosis or occlusion has been reported to be associated with mortality; therefore, the management of thrombotic complications remains a challenge for most congenital cardiovascular surgeons. Despite its importance, the optimal method for shunt anastomosis remains unclear.

Objective: The study investigates the clinical benefits of the punch-out technique over conventional methods in the anastomosis process of Systemic-to-pulmonary shunt, focusing on its potential to reduce shunt-related complications.

Methods: Anastomotic models were created by two different surgeons employing both traditional slit and innovative punch-out techniques. Computational tomography was performed to construct three-dimensional models for computational fluid dynamics (CFD) analysis. We assessed the flow pattern, helicity, magnitude of wall shear stress, and its gradient.

Results: The anastomotic flow area was larger in the model using the punch-out technique than in the slit model. In CFD simulation, we found that using the punch-out technique decreases the likelihood of establishing a high wall shear stress distribution around the anastomosis line in the model.

Conclusion: The punch-out technique emerges as a promising method in SPS anastomosis, offering a reproducible and less skill-dependent alternative that potentially diminishes the risk of shunt occlusion, thereby enhancing patient outcomes.

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评估全身-肺分流术中打孔技术的功效:计算流体动力学方法。
背景:全身-肺分流术是一种用于减少先天性心脏病肺血流量的姑息性手术。据报道,分流管狭窄或闭塞与死亡率有关;因此,血栓并发症的处理仍然是大多数先天性心血管外科医生面临的挑战。尽管分流吻合术非常重要,但其最佳方法仍不明确:本研究探讨了在系统-肺分流术吻合过程中,打孔技术相对于传统方法的临床优势,重点关注其减少分流术相关并发症的潜力:方法:两位不同的外科医生采用传统的缝合技术和创新的打孔技术制作了吻合口模型。方法:两位不同的外科医生分别采用传统的缝合技术和创新的打孔技术制作了吻合口模型,并通过计算断层扫描技术构建了用于计算流体动力学(CFD)分析的三维模型。我们评估了流动模式、螺旋度、壁剪应力大小及其梯度:结果:与狭缝模型相比,采用打孔技术的模型吻合口血流面积更大。在 CFD 模拟中,我们发现使用打孔技术降低了在模型吻合口周围形成高壁剪应力分布的可能性:结论:打孔技术在 SPS 吻合术中是一种很有前途的方法,它提供了一种可重复性强、对技术依赖性较低的替代方法,有可能降低分流管闭塞的风险,从而改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bio-medical materials and engineering
Bio-medical materials and engineering 工程技术-材料科学:生物材料
CiteScore
1.80
自引率
0.00%
发文量
73
审稿时长
6 months
期刊介绍: The aim of Bio-Medical Materials and Engineering is to promote the welfare of humans and to help them keep healthy. This international journal is an interdisciplinary journal that publishes original research papers, review articles and brief notes on materials and engineering for biological and medical systems. Articles in this peer-reviewed journal cover a wide range of topics, including, but not limited to: Engineering as applied to improving diagnosis, therapy, and prevention of disease and injury, and better substitutes for damaged or disabled human organs; Studies of biomaterial interactions with the human body, bio-compatibility, interfacial and interaction problems; Biomechanical behavior under biological and/or medical conditions; Mechanical and biological properties of membrane biomaterials; Cellular and tissue engineering, physiological, biophysical, biochemical bioengineering aspects; Implant failure fields and degradation of implants. Biomimetics engineering and materials including system analysis as supporter for aged people and as rehabilitation; Bioengineering and materials technology as applied to the decontamination against environmental problems; Biosensors, bioreactors, bioprocess instrumentation and control system; Application to food engineering; Standardization problems on biomaterials and related products; Assessment of reliability and safety of biomedical materials and man-machine systems; and Product liability of biomaterials and related products.
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