Computational fluid dynamics simulations of flow distribution and graft designs in apicoaortic bypass
Computational fluid dynamics simulations of flow distribution and graft designs in apicoaortic bypass
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心尖主动脉旁路中流量分布和移植物设计的计算流体动力学模拟
DOI：
10.1007/s11748-020-01527-8
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发表时间：
2020
影响因子：
1.2
通讯作者：
Nitta Takashi
中科院分区：
文献类型：
--
作者：
Sasaki Takashi;Ueda Hitomi;Itatani Keiichi;Suzuki Kenji;Kurita Jiro;Sakamoto Shun-ichiro;Miyagi Yasuo;Ishii Yosuke;Morota Tetsuro;Nitta Takashi
心尖主动脉旁路有双出口，其移植物设计类似于左心室辅助装置（LVAD）。左心室心尖至降主动脉旁路术（LV-DsAo）是目前广泛应用的心尖-主动脉旁路术。相比之下，左心室心尖至升主动脉（LV-AsAo）旁路是LVAD手术的标准。本研究的目的是评估apicoaortic旁路移植物的设计及其对流量分布和能量损失（EL）的影响。MethodsA模拟研究，使用计算流体动力学的几何形状和血流动力学数据从一个30岁的病人谁接受了左心室DsAo旁路。通过升主动脉（AsAo）和心尖主动脉导管的心输出量（CO）比例设定为50：50、30：70和10：90。计算不同分布比例的局部血流量（RBF）和EL。结果在分流比为50：50时，左室-DsAo分流术的RBF对头部和EL分别占总CO的16.4%和62.0 mW，左室-AsAo分流术的RBF对头部和EL分别占总CO的32.3%和81.5 mW。在LV-DsAo转流中，随着通过AsAo的CO的增加，到头部的RBF减小，而在LV-AsAo转流中，到头部的RBF不变。结论LV-DsAo和LV-AsAo旁路的局部血流分布不同，但与AsAo的CO呈负相关的EL趋势相似。
ObjectiveApicoaortic bypass has double outlets and its graft design is similar to that of a left ventricular assist device (LVAD). The left ventricular apex to the descending aorta (LV-DsAo) bypass is widely used in apicoaortic bypass. In contrast, the left ventricular apex to the ascending aorta (LV-AsAo) bypass is standard in LVAD surgery. This study aimed to evaluate the graft designs of apicoaortic bypass and their effects on flow distribution and energy loss (EL).MethodsA simulation study using computational fluid dynamics was performed on the geometry and hemodynamics data obtained from a 30-year-old patient who underwent a LV-DsAo bypass. The ratio of the cardiac output (CO) through the ascending aorta (AsAo) and apicoaortic conduit was set at 50:50, 30:70, and 10:90. Regional blood flow (RBF) and EL were calculated for the different distribution ratios. As an alternative to the LV-DsAo bypass, a virtual LV-AsAo bypass surgery was performed, and each parameter was compared with that of the LV-DsAo bypass.ResultsAt a distribution ratio of 50:50, the RBF to the head and EL were 16.4% of the total CO and 62.0 mW in the LV-DsAo bypass, and 32.3% and 81.5 mW in the LV-AsAo bypass, respectively. The RBF to the head decreased with the CO through the AsAo in the LV-DsAo bypass, but it was constant in the LV-AsAo bypass. The EL increased inversely with the CO through the AsAo in both graft designs.ConclusionThe regional blood flow distribution was different, but the trend of the EL which increased inversely with the CO through the AsAo was similar between the LV-DsAo and LV-AsAo bypasses.
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