Towards virtual surgery planning: the modified Blalock-Taussig Shunt

Abstract

A modified Blalock-Taussig shunt (MBTS) is an aortopulmonary shunt to establish or augment pulmonary perfusion in congenital cardiac defects with limited pulmonary blood flow. Proper function of this shunt is of utmost importance. In clinical practice, prediction of flow in an MBTS relies on previous experience. In the research field, computational modeling techniques have been developed to simulate flow in an MBTS and predict its performance. These techniques are promising but also time consuming and prone to uncertainties; therefore not yet suitable for clinical practice. Here we present a simplified, patient-based computational model to predict mean circulatory flow characteristics after MBTS insertion. Simulations performed over a range of pulmonary vascular resistances, were compared to data from: i) previous modeling studies; ii) data from the specific patient modeled, and iii) a cohort of patients with MBTS. Model predictions were within one standard deviation from cohort data; and within 1% from results of previous (more complex) computational models. In comparison to previous studies, our model is computationally stable with significantly shorter computational time to perform simulations. We envision that our approach could be used in the future to perform virtual surgeries, quickly testing different surgical scenarios using the patient own geometrical and physiological characteristics, to aid surgeons in decision making.