HEMODYNAMICS-BASED LONG-TERM PATENCY OF DIFFERENT SEQUENTIAL GRAFTING: A PATIENT-SPECIFIC MULTI-SCALE STUDY
HEMODYNAMICS-BASED LONG-TERM PATENCY OF DIFFERENT SEQUENTIAL GRAFTING: A PATIENT-SPECIFIC MULTI-SCALE STUDY
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基于血流动力学的不同顺序移植的长期通畅：针对患者的多尺度研究
DOI：
10.1142/s0219519417500178
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发表时间：
2017-02
影响因子：
0.8
通讯作者：
Qiao Aike
中科院分区：
文献类型：
--
作者：
Wang Wenxin;Liu Youjun;Zhao Xi;Xie Jinsheng;Qiao Aike
背景与目的：序贯移植术是冠状动脉旁路移植术（CABG）中最常见的手术方式之一。但不同的移植部位对血流动力学和移植血管通畅性的影响尚不清楚。材料与方法：采用零维/三维（0 D/3D）耦合方法完成了两种不同的连续嫁接模型的多尺度模拟。首先，基于冠状动脉计算机断层扫描血管造影（CCTA）图像重建患者特定的3D模型。通过使用虚拟手术，在该患者特定的3D模型上实现了两种不同的连续移植。因此，建立了两种不同的术后3D模型。然后，基于患者的生理数据建立集总参数模型（LPM; 0 D）来模拟心血管系统。最后，使用0 D/3D耦合方法通过耦合心血管系统的0 D LPM和患者特定的3D模型来执行数值模拟。此外，本文还对这两种不同顺序移植的长期通畅性进行了讨论。结果：计算并显示了冠状动脉血流速度和移植血管流量。计算了瞬时无波比（iFR）。两种连续移植物的术后iFR值均增加至0.90以上。并对血流动力学参数如壁面切应力（WSS）、振荡剪切指数（OSI）进行了分析。模型1的低WSS面积远小于模型2。模型2中存在两个高OSI区域，而模型1中只有一个。结论：两种模型的短期疗效无显著差异。但模型2的长期通畅性较差。模型1可以提高移植的长期通畅性，当需要进行顺序移植时，应优先考虑。
Background and aims: Sequential grafting is one of the common coronary artery bypass grafting (CABG) surgery. But the influence of the sequential grafting position on hemodynamics and the graft patency is still unclear. Materials and methods: The zero-dimensional/three-dimensional (0D/3D) coupling method was used to finalize the multi-scale simulation of two different sequential grafting models. First, a patient-specific 3D model was reconstructed based on coronary computed tomography angiography (CCTA) images. Two different sequential grafts were implemented on this patient-specific 3D model by using virtual surgery. Thus, two different postoperative 3D models were built. Then, a lumped parameter model (LPM; 0D) was built based on the patient physiological data to simulate the cardiovascular system. Finally, the 0D/3D coupling method was used to perform the numerical simulation by coupling a 0D LPM of the cardiovascular system and the patient-specific 3D models. Moreover, the long-term patency of these two different sequential grafts was discussed in this paper. Results: The coronary flow rate and the graft flow were calculated and illustrated. The instantaneous wave-free ratio (iFR) were calculated. Postoperative iFR values increase to over 0.90 for both sequential grafts. Some hemodynamics parameters were also illustrated, such as wall shear stress (WSS), oscillatory shear index (OSI). The area of low WSS in Model 1 was much less than that in Model 2. Two regions of high OSI exist in Model 2, while only one in Model 1. Conclusions: No significant differences exist on the short-term outcomes of two models. But the long-term patency of Model 2 was worse. The Model 1 may enhance long-term patency of grafting and should be priority when the sequential grafting need to be carried out.
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DOI：
10.1016/s0022-5223(19)36000-3
发表时间：
1986-05
期刊：
The Journal of thoracic and cardiovascular surgery
影响因子：
--
作者：
G. Fitzgibbon;A. Leach;W. Keon;J. Burton;H. Kafka
通讯作者：
G. Fitzgibbon;A. Leach;W. Keon;J. Burton;H. Kafka
影响因子：
3.8
作者：
R. Leask;J. Butany;K. Johnston;C. Ethier;M. Ojha
通讯作者：
R. Leask;J. Butany;K. Johnston;C. Ethier;M. Ojha
影响因子：
24
作者：
Sen, Sayan;Asrress, Kaleab N.;Davies, Justin E.
通讯作者：
Davies, Justin E.
影响因子：
37.8
作者：
W. Weintraub;E. Jones;D. Morris;S. King;R. Guyton;J. Craver
通讯作者：
W. Weintraub;E. Jones;D. Morris;S. King;R. Guyton;J. Craver
影响因子：
1.8
作者：
通讯作者：
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