{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:59:24Z","timestamp":1790837964440,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006792","name":"Hartwell Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006792","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Univentricular circulations are initially established with the placement of a fixed\u2010diameter blood shunt to facilitate physiologic stability during growth. This fixed\u2010diameter shunt (FDS) is geometrically static in a dynamically growth\u2010driven environment. The neonatal cardiovascular hemodynamics are sensitive to the presence of the FDS and its fluidic and resistive properties, which creates significant interdependency and mortality risks. Thus, we have developed a geometrically tunable shunt to mitigate these hemodynamic challenges. Here, the tunable shunt is established by computational characterization of the hemodynamics over shunt usage in a patient specific anatomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      Two multiscale cardiovascular models were implemented at time\u2010points spanning across the beginning and end of the shunt\u2010use period. These models were customized with patient\u2010specific data from a clinical trial, drawing on observed geometric and fluidic conditions. A patient growth model between time\u2010points was also established. For two patients, the tunable shunt was simulated across those time\u2010points to identify the appropriate diameter changes that produced favorable hemodynamic conditions, per the pulmonary\u2010to\u2010systemic flow ratio (\n                      <jats:italic>Q<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>P<\/jats:italic>\n                      <\/jats:sub>\n                      \/\n                      <jats:italic>Q<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>S<\/jats:italic>\n                      <\/jats:sub>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Changes in vessel morphology, cardiac output, and vascular resistance were characterized and represented growth in the shunt\u2010use period. Compared to the diameter at the beginning of the shunt\u2010use period, a diameter expansion of 12%\u201313% was required at the end of the shunt\u2010use period to balance the\n                      <jats:italic>Q<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>P<\/jats:italic>\n                      <\/jats:sub>\n                      \/\n                      <jats:italic>Q<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>S<\/jats:italic>\n                      <\/jats:sub>\n                      for optimal blood oxygenation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These models are among the first to computationally study clinical time\u2010points early in the post\u2010operative univentricular patient. Using a complex model of growth, the tunable shunt design was investigated for its potential to alter and maintain hemodynamics over the growth months of infancy. These findings advanced the development of an innovative, tunable blood shunt for high\u2010risk patients with complex congenital heart disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70244","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:32:33Z","timestamp":1790836353000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiscale Modeling of a Geometrically Tunable Shunt for Growing Pediatric Patients With Single Ventricle Physiology"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3773-8928","authenticated-orcid":false,"given":"Ellen E.","family":"Garven","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering, Science and Health Systems Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2532-2458","authenticated-orcid":false,"given":"Ethan","family":"Kung","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Department of Bioengineering Clemson University  Clemson South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8454-6956","authenticated-orcid":false,"given":"Randy M.","family":"Stevens","sequence":"additional","affiliation":[{"name":"St. Christopher's Hospital for Children  Philadelphia Pennsylvania USA"},{"name":"Pediatrics, College of Medicine Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2168-0802","authenticated-orcid":false,"given":"Christopher B.","family":"Rodell","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Science and Health Systems Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3610-4499","authenticated-orcid":false,"given":"Amy L.","family":"Throckmorton","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering, Science and Health Systems Drexel University  Philadelphia Pennsylvania USA"},{"name":"Pediatrics, College of Medicine Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.05.059.Prevalence"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012\u20103435.Temporal"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1589"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2010.09.015"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119\u2010023\u201000326\u20105"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.04.028"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029375"},{"key":"e_1_2_10_9_1","first-page":"1","article-title":"Mortality in the United States, 2020","volume":"427","author":"Murphy S. 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