Simulating Crocodilian Cardiac Shunting for Insights into Human Congenital Heart Disease Treatment

Congenital heart diseases (CHDs) are the most common structural and functional abnormalities of the heart, affecting approximately 1.35 million newborns each year. Despite advancements in diagnosis and surgical techniques, mortality and long-term complications remain significant concerns. Therefore, novel approaches are needed to improve our understanding and management of these conditions. By studying the cardiac anatomy of animal species with structures that are similar to those found in congenital heart diseases, new strategies may be developed to improve the management and surgical treatment of these conditions.

This study highlights that some defects and abnormalities found in patients with congenital heart diseases are similar to structures found in the crocodilian heart, where they serve adaptive functions. The unique anatomical features of crocodilians—including the mixing of oxygen-poor and oxygen-rich blood, right ventricular hypertrophy, and increased pulmonary resistance— resemble pathological conditions observed in cyanotic congenital heart diseases. These features are closely linked to shunting mechanisms that play a critical role in maintaining circulation under pressure or oxygen imbalance. However, crocodilians adapt to changes in pressure and volume without developing pathological complications. In this study, high-fidelity simulations of crocodilian blood flow dynamics are conducted to investigate the functional pathways of the crocodilian heart and examine the role of specific anatomical structures that could potentially be adapted for surgical applications in children with CHDs. Moreover, further investigation into how each structure contributes to oxygen distribution within the cardiac cycle could be valuable for developing new strategies to prevent complications that often arise after surgical repair.