Hybrid stage I palliation for hypoplastic left heart syndrome has no advantage on ventricular energetics: a theoretical analysis

Shuji Shimizu, Toru Kawada, Dai Une, Toshiaki Shishido, Atsunori Kamiya, Shunji Sano, Masaru Sugimachi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A hybrid procedure combining bilateral pulmonary artery banding with ductal stenting has recently been used as stage I palliation for hypoplastic left heart syndrome. However, the advantage of the hybrid procedure over the Norwood procedure on ventricular energetics remains unclear. To clarify this, we performed a computational analysis with a combination of time-varying elastance chamber model and modified three-element Windkessel vascular model. Although mean pulmonary artery (PA) pressure, pulmonary flow, and oxygen saturation were almost equivalent with the Norwood procedure, the hybrid procedure delivered higher systolic and lower diastolic systemic arterial pressures compared to the Norwood procedure with right ventricle (RV) to PA shunt. As a result, the hybrid procedure yielded increased systolic pressure–volume area and impaired mechanical efficiency. Therefore, the hybrid procedure has probably no advantage on ventricular energetics compared to the Norwood procedure with a RV-PA shunt.

Original languageEnglish
Pages (from-to)105-113
Number of pages9
JournalHeart and Vessels
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Keywords

  • Computational model
  • Hybrid procedure
  • Hypoplastic left heart syndrome
  • Norwood procedure
  • Ventricular energetics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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