Key result
An in vitro experimental model of the Sano variant of the Norwood operation demonstrated physiological and repeatable pressure and flow signals, confirming its feasibility for testing HLHS palliations.
This in vitro experimental model successfully simulates the Sano modification of the Norwood operation, providing a platform for comparing first-stage palliation variations and validating computational models.
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May facilitate preclinical HLHS palliation testing; leaves open clinical translation pending in vivo validation.
This study describes the implementation of an experimental model of the "Sano" variant (right-ventricle to pulmonary-artery shunt) of the Norwood operation used to treat hypoplastic left-heart syndrome (HLHS). The Sano operation is an alternative to the modified Blalock-Taussig shunt (innominate to pulmonary artery shunt). In the experimental setup, the single ventricle is simulated using a Berlin Heart Excor ventricular assist device and the Sano shunt is constructed by attaching a Tygon tube (6 mm internal diameter, 40 mm long) to the perforated de-airing valve of the Berlin Heart at one end, and to a pulmonary compliance chamber at the other end. The feasibility of the setup was verified by testing two rapid-prototyped patient-specific anatomical models (one without and one with aortic coarctation) under pulsatile flow conditions typical of Norwood patients. Results showed physiological and repeatable pressure and flow signals, as well as physiological values for pulmonary and aortic flow. Shunt flow was regulated by shunt size, and diastolic runoff through the shunt was also observed, both being features of Sano physiology. This system allows for comparing variations of first stage palliation of HLHS in vitro, and it also represents a source of data for validation of computational models.
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Biglino et al. (2012) studied Hypoplastic left heart syndrome (HLHS) (n=2). Sano variant (right-ventricle to pulmonary-artery shunt) experimental model was evaluated on Feasibility of the setup (physiological and repeatable pressure and flow signals). An in vitro experimental model of the Sano variant of the Norwood operation demonstrated physiological and repeatable pressure and flow signals, confirming its feasibility for testing HLHS palliations.
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