{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T17:19:38Z","timestamp":1769707178363,"version":"3.49.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"\n Objectives<\/jats:title>\n Reverse Potts shunt is a promising yet high-risk therapy for pediatric pulmonary arterial hypertension. Postoperative hemodynamics is critically influenced by shunt configuration but is difficult to predict. This study aimed to quantify the effects of shunt size and location on hemodynamics to guide surgical planning.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Based on a patient-specific model, four postoperative models with two different shunt locations [left pulmonary artery (LPA)\u2013descending aorta (DAO) and pulmonary artery bifurcation\u2013aortic arch] and three conduit sizes (4, 5, and 6\u00a0mm) were created. The direct Potts shunt model was created by a direct side-to-side anastomosis between the LPA and DAO with a 6-mm circular opening. Quantitative parameters including the shunt ratio (SR), which was defined as the percentage of the shunt flow rates to the total pulmonary inflow rate, lower limb oxygen saturation, and pressure were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Increasing the shunt size from 4\u00a0mm to 6\u00a0mm elevated the SR from 6.01% to 9.80%, concurrently reducing lower limb oxygen saturation from 89.57% to 86.52%. When taking 11,000\u00a0Pa as the threshold, this increased SR resulted in a reduction of the high-pressure area from 17.32% of the total pulmonary artery area to almost zero. Meanwhile, the high-pressure area on the aorta expanded from 8.72% of the total aortic area to 14.94%. These results indicated a reduction in the right ventricular afterload and an increase in the left ventricular afterload. Notably, a 6-mm shunt at the pulmonary artery bifurcation yielded a significantly larger SR than at the LPA (9.80% vs. 2.68%), which is attributed to a higher pressure gradient at the pulmonary artery bifurcation (1,201\u00a0Pa vs. 162\u00a0Pa).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The shunt location had a greater impact on the SR than shunt size within the 4\u00a0mm\u20136\u00a0mm range in this specific case. A 6-mm shunt at the pulmonary artery bifurcation yielded a significantly larger SR than at the LPA, which is attributed to the higher preoperative pressure gradient at the bifurcation site. Left heart function is as critical as right heart function in maintaining pressure balance and determining outcomes, as the shunt flow increases the left ventricular afterload.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fbioe.2025.1697468","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:42:53Z","timestamp":1769668973000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Shunt configuration\u2019s role in shaping hemodynamics of reverse Potts shunt in pediatric pulmonary arterial hypertension"],"prefix":"10.3389","volume":"13","author":[{"given":"Jinlong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Institute for Pediatric Congenital Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Pediatric Translational Medicine, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiafeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwen","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Institute for Pediatric Congenital Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Pediatric Translational Medicine, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Yan","sequence":"additional","affiliation":[{"name":"Shanghai Institute for Pediatric Congenital Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Institute of Pediatric Translational Medicine, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanjun","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumin","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Institute for Pediatric Congenital Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]},{"name":"Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease, Shanghai Children\u2019s Medical Center, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e011315","DOI":"10.1161\/circinterventions.121.011315","article-title":"Transcatheter nonductal reverse potts shunt creation in pulmonary arterial hypertension","volume":"15","author":"Anderson","year":"2022","journal-title":"Circ. 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