Evidence map›Paper›PMID 42097536›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2026

Simulations predict improved valve performance without direct leaflet intervention after neonatal truncus arteriosus repair.

Karoline-Marie Bornemann, Perry S Choi, Jay Huber, Alexander K Reed, Amit Sharir, Shiraz A Maskatia, Alison L Marsden, Michael R Ma, Alexander D Kaiser

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In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Karoline-Marie BornemannDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, Calif; Maternal & Child Health Research Institute, Stanford University, Stanford, Calif.
Perry S ChoiMaternal & Child Health Research Institute, Stanford University, Stanford, Calif; Department of Cardiothoracic Surgery, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif.
Jay HuberDepartment of Cardiothoracic Surgery, Stanford University, Stanford, Calif.
Alexander K ReedDepartment of Cardiothoracic Surgery, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif.
Amit SharirDepartment of Cardiothoracic Surgery, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif.
Shiraz A MaskatiaDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, Calif; Maternal & Child Health Research Institute, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif.
Alison L MarsdenDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University, Stanford, Calif; Maternal & Child Health Research Institute, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif; Department of Bioengineering, Stanford University, Stanford, Calif; Institute for Computational & Mathematical Engineering, Stanford University, Stanford, Calif.
Michael R MaMaternal & Child Health Research Institute, Stanford University, Stanford, Calif; Department of Cardiothoracic Surgery, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif.
Alexander D KaiserMaternal & Child Health Research Institute, Stanford University, Stanford, Calif; Department of Cardiothoracic Surgery, Stanford University, Stanford, Calif; Cardiovascular Institute, Stanford University, Stanford, Calif. Electronic address: alexdkaiser@stanford.edu.

Funding

A multi-physics simulator for pediatric cardiac surgical planningR01HL173845 · NHLBI · STANFORD UNIVERSITY · PI Daniel B Ennis, MICHAEL MA · 2024 to 2026
$2.3M
Stanford Integrated Cardiovascular/Pulmonary Residency Research Training ProgramR38HL143615 · NHLBI · STANFORD UNIVERSITY · PI Michael Peter Fischbein, Marlene Rabinovitch · 2020 to 2026
$2.2M
Optimizing Congenital Aortic Valve Surgery with Simulation-Guided DesignK25HL175208 · NHLBI · STANFORD UNIVERSITY · PI Alexander D Kaiser · 2024 to 2026
$545k
American Heart Association-American Stroke Association 24CDA1272816NHLBI NIH HHS K25 HL175208NHLBI NIH HHS R01 HL173845NHLBI NIH HHS R38 HL143615
6 · The paper itself

Abstract

objectivesTruncus arteriosus (TA) is a rare and severe congenital heart disease. Quadricuspid valve morphology occurs in 25% of patients with TA and is associated with regurgitation and increased risk of reoperation. It remains unclear how sudden hemodynamic changes after TA repair alter valve performance. This study simulated pre- and postoperative conditions investigating valve performance without leaflet intervention. We hypothesized that valve performance can be predicted in silico, matching in vivo imaging and identifying mechanisms by which postoperative hemodynamics will reduce valve regurgitation.

methodsPre- and postoperative computed tomography images of a neonate with a quadricuspid valve were segmented. Free edge length and geometric height from the patient's echocardiogram were used for valve modeling. Fluid-structure interaction simulations of the coupled dynamics of the valve and blood were performed. Boundary conditions were tuned to match patient-specific clinical values, including the pulmonary-to-systemic flow ratio.

resultsThe preoperative simulation confirmed mild valve regurgitation observed in vivo. The combination of geometrically complex vessels and heterogeneous in- and outflow of the valve resulted in asymmetric valve opening and closing. Poor central leaflet coaptation led to a central regurgitant jet directed toward the septum. Altered postoperative hemodynamic conditions improved coaptation and eliminated regurgitation in silico, matching observed in vivo valve performance.

conclusionsThis modeling approach reproduced in vivo valve performance and identified mechanisms improving postoperative coaptation. TA repair led to elimination of regurgitation via enhanced central coaptation through favorable fluid-valve interaction. Thus, altered postoperative hemodynamics after TA repair may improve valve performance without leaflet intervention.

Indexed as

Cardiac Surgical ProceduresComputer SimulationHeart ValvesModels, CardiovascularTruncus ArteriosusTruncus Arteriosus, PersistentHemodynamicsHumansInfant, NewbornTomography, X-Ray ComputedTreatment Outcomecongenital valve repairfluid-structure interactionneonatal congenital surgeryquadricuspid valvetruncus arteriosusvalve simulations

Identifiers

PMID42097536
PMCPMC13225876

What OpenQuestion holds

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None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.