Norwood procedure with non-valved right ventricle to pulmonary artery shunt improves ventricular energetics despite the presence of diastolic regurgitation: A theoretical analysis

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

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

When the Norwood procedure is conducted for the hypoplastic left heart syndrome using a non-valved right ventricle (RV) to pulmonary artery (PA) shunt, diastolic regurgitation from PA to RV may have an adverse effect on postoperative hemodynamics. In this study, we examined the impact of the diastolic regurgitation on ventricular energetics by computational analysis using a combination of a time-varying elastance chamber model and a modified three-element Windkessel vascular model. This study revealed that use of the valved or non-valved RV-PA shunt eliminated pulmonary over-circulation which was observed when using the systemic to pulmonary artery shunt (modified Blalock-Taussig shunt). Although the valved RV-PA shunt improved pulmonary blood supply and consequently increased pulmonary artery flow and oxygen saturation compared to the non-valved RV-PA shunt, the non-valved RV-PA shunt improved ventricular energetics in spite of the presence of PA to RV regurgitation.

Original languageEnglish
Pages (from-to)457-465
Number of pages9
JournalJournal of Physiological Sciences
Volume61
Issue number6
DOIs
Publication statusPublished - Nov 1 2011

Keywords

  • Computational model
  • Hypoplastic left heart syndrome
  • Norwood procedure
  • Right ventricle to pulmonary artery shunt
  • Valved
  • Ventricular energetics

ASJC Scopus subject areas

  • Physiology

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