Potts shunt for suprasystemic pulmonary artery hypertension: decision-making and design

Potts 分流术治疗体系统性肺动脉高压：决策和设计

• 批准号: EP/R010811/1
• 负责人: Sanjay Pant
• 金额: $ 12.85万
• 依托单位: Swansea University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FR010811%2F1
• 关键词: Potts; shunt; suprasystemic; pulmonary; artery

The human cardiovascular system consists of two large arteries: the aorta (AO), which supplies oxygenated blood to the body, and the pulmonary artery (PA), which supplies deoxygenated blood to the lungs for oxygenation. In healthy individuals, the pressure in the AO is significantly higher than the pressure in the PA. Pulmonary artery hypertension (PAH) is a disease in which the PA pressure is abnormally elevated and is classified as one of the most devastating disorders by the pulmonary artery association UK. This is evidenced by a mean survival time after diagnosis of less than 30 months in adults and less than 12 months in children. A recently proposed treatment for severe PAH, i.e. the case when PA pressure is higher than the pressure in AO, is to create a connection, known as the Potts shunt, between the PA and the AO. Just as a connection between two pipes carrying fluids with high and low pressures will lead to a reduction of pressure in the high-pressure pipe and an increase of pressure in the low-pressure pipe, the idea is that a Potts shunt can lead to a reduction of PA pressure in severe PAH patients. This reduction in PA pressure is desirable but will also result in mixing of oxygenated and deoxygenated blood, an undesirable effect. Clinical experience has shown favourable results of this treatment in some patients and unfavourable in others, which is attributed largely to a reduction in cardiac output, the total volume of blood ejected by the heart in one cardiac cycle. This project aims to develop computational models to assess three measures of Potts shunt treatment:1) reduction of pulmonary artery pressure,2) mixing of oxygenated and deoxygenated blood, and3) reduction in cardiac output. Through the computational models, this project will assess the mechanisms behind the success/failure of Potts shunt in relation to the above measures. The end-product will be a computer model which, given a new patient, can determine if a Potts shunt is likely to succeed in the patient. Furthermore, technology to optimise the design of Potts shunt for each patient individually, such that maximal clinical benefit is achieved, will be developed.

人体心血管系统由两条大动脉组成：主动脉（AO），向身体供应含氧血液;肺动脉（PA），向肺部供应脱氧血液进行氧合。在健康个体中，AO中的压力显著高于PA中的压力。肺动脉高压（PAH）是一种PA压力异常升高的疾病，被英国肺动脉协会列为最具破坏性的疾病之一。诊断后的平均生存时间在成人中小于30个月，在儿童中小于12个月，证明了这一点。最近提出的重度PAH（即PA压力高于AO中压力的情况）的治疗方法是在PA和AO之间建立连接，称为Potts分流。正如输送高压和低压流体的两个管道之间的连接将导致高压管道中的压力降低和低压管道中的压力增加一样，该想法是Potts分流器可以导致重度PAH患者的PA压力降低。PA压力的这种降低是期望的，但也将导致氧合血液和脱氧血液的混合，这是不期望的效果。临床经验表明，这种治疗在一些患者中效果良好，而在另一些患者中效果不佳，这主要归因于心输出量减少，心输出量是心脏在一个心动周期中排出的血液总量。该项目旨在开发计算模型来评估Potts分流治疗的三个指标：1）降低肺动脉压，2）混合氧合血和脱氧血，3）减少心输出量。通过计算模型，本项目将评估与上述措施相关的Potts分流术成功/失败背后的机制。最终产品将是一个计算机模型，如果有一个新的病人，它可以确定波茨分流术是否有可能在病人身上成功。此外，还将开发针对每位患者优化Potts分流管设计的技术，以实现最大临床受益。

项目成果

Beyond Newton: A New Root-Finding Fixed-Point Iteration for Nonlinear Equations

超越牛顿：非线性方程的新求根定点迭代

• DOI: 10.3390/a13040078
• 发表时间: 2020
• 期刊: Algorithms
• 影响因子: 2.3
• 作者: Aggarwal A

A physiologically realistic virtual patient database for the study of arterial haemodynamics

用于动脉血流动力学研究的生理真实虚拟患者数据库

• DOI: 10.48550/arxiv.2102.10655
• 发表时间: 2021
• 作者: Jones G

Machine learning for detection of stenoses and aneurysms: application in a physiologically realistic virtual patient database.

• DOI: 10.1007/s10237-021-01497-7
• 发表时间: 2021-12
• 期刊: Biomechanics and modeling in mechanobiology
• 影响因子: 3.5
• 作者: Jones G;Parr J;Nithiarasu P;Pant S
• 通讯作者: Pant S

An Information-Theoretic Framework for Optimal Design: Analysis of Protocols for Estimating Soft Tissue Parameters in Biaxial Experiments

• DOI: 10.3390/axioms10020079
• 发表时间: 2021-06-01
• 期刊: AXIOMS
• 影响因子: 2
• 作者: Aggarwal, Ankush;Lombardi, Damiano;Pant, Sanjay
• 通讯作者: Pant, Sanjay

Machine learning for detection of stenoses and aneurysms: application in a physiologically realistic virtual patient database

用于检测狭窄和动脉瘤的机器学习：在生理真实的虚拟患者数据库中的应用

• DOI: 10.48550/arxiv.2103.00599
• 发表时间: 2021
• 作者: Jones G