Effectiveness of Blalock-Taussig shunt performance in the congenital heart disease children

A problem of congenital heart defects with obstruction of the right ventricle output tract is urgent because of disease severity and need for multistage surgical treatment. The first stage of surgical correction is system-pulmonary shunt installation. Nevertheless, there are controversial views on the choice of the shunt optimal diameter and the implantation place selection. Anastomosis should provide sufficient, but no excessive pulmonary blood flow without reducing cardiac output, pulmonary vessels damage, and provide uniform growth of pulmonary arteries. In this paper, the model of blood flow in "aorta-shunt-pulmonary artery" is considered. A set of geometric images was obtained in four patients for the further import into ANSYS CFX finite element solver to solve the hemodynamic problem. Three variants of the modified Blalock-Taussig shunt installation were analyzed with by using widely adopted hemodynamic indices (wall shear stress, time-averaged wall shear stress, oscillatory shear index, relative residence time). It was shown that shunting options differ for the various patients. Moreover, flow asymmetry in the pulmonary arteries at different implantation sites was noticed. Also, a comparison of hemodynamic performance was made to assess the effectiveness of the modified Blalock-Taussig shunt. An objectivized and personalized approach to specific treatment of each patient will significantly reduce child mortality and improve the quality of rehabilitation.