Application of mathematical modelling for the evaluation of the results of systemiс-pulmonary shunts formation
Authors: Sinelnikov Yu. , Arutunyan V. , Porodikov A. , Biyanov А. , Tuktamyshev V. , Shmurak M. , Khairulin A. , Kuchumov A. 
Published: September 2020

Surgical treatment of congenital heart defects with the obstruction of the outflow tract of the right ventricle can be performed in several stages. The first stage of surgical correction is the creation of a systemic-pulmonary shunt, followed by radical correction. The main complications of systemic-pulmonary shunts are associated with the development of shunt thrombosis and hypervolemia of the pulmonary circulation. Currently, considering the importance of individual selection of a shunt for effective functioning, the main scientific search is aimed at creating optimal methods that consider all the hemodynamic features of a particular patient. Recently, the direction of mathematical modelling and biomechanical analysis in medicine has been actively developing, facilitating the objective evaluation of the accumulated clinical experience and is one of the main tools in evidence-based medicine. The use of computational fluid dynamics methods for modified Blalock–Taussig shunt analysis allows us evaluate the hemodynamic parameters for various configurations of shunts and anastomosis angles and improve the understanding of pathophysiological processes in the cardiovascular system before or after an application of the modified Blalock–Taussig shunt. Here, we provide an overview of the work related to the use of modelling for the calculation of the currents in the aorta–shunt–pulmonary artery system. It is noteworthy that most studies consider the personalised characteristics of the patients and are therefore highly likely to be used in clinical practice. The main hemodynamic parameters that are analysed with the computer calculations are described. Part of the work is devoted to the stages of computer modelling and the limitations in the implementation of these stages. We believe that this manuscript will be of interest to specialists in cardiovascular surgery and to the several scholars working in areas related to the use of digital technologies in medicine, mathematical modelling in medicine and biomechanics.
Received 30 January 2020. Revised 25 May 2020. Accepted 9 June 2020.
Conflict of interest: Authors declare no conflict of interest.
Funding: The work is supported by the program for the development of the Scientific and Educational Mathematical Center of the Volga Federal District (No. 075-02-2020-1478) and a grant for the development of the scientific school of the Perm Region “Computer biomechanics and digital technologies in biomedicine”.
Author contributionsConception and design: Yu.S. Sinelnikov, V.B. Arutunyan, A.A. Porodikov, A.N. Biyanov, V.S. Tuktamyshev, M.I. Shmurak, A.R. KhairulinDrafting the article: A.A. Porodikov, A.N. Biyanov, A.G. KuchumovCritical revision of the article: A.N. Biyanov, A.G. KuchumovFinal approval of the version to be published: Yu.S. Sinelnikov, V.B. Arutunyan, A.A. Porodikov, A.N. Biyanov, V.S. Tuktamyshev, M.I. Shmurak, A.R. Khairulin, A.G. Kuchumov