Fluid-structure interaction in aortic cross-clamping: implications for vessel injury.
Fluid-structure interaction in aortic cross-clamping: implications for vessel injury.
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DOI：
10.1016/j.jbiomech.2009.08.042
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发表时间：
2010-01-19
影响因子：
2.4
通讯作者：
Kassab GS
中科院分区：
文献类型：
--
作者：
Chen HY;Navia JA;Shafique S;Kassab GS
血管交叉钳夹应用于许多心血管手术，例如冠状动脉搭桥、主动脉修复和瓣膜手术。实验研究发现，不同程度的夹紧会对动脉造成损伤。这项研究探讨了流行的夹子对血管壁的影响。主动脉和夹子的模型是在计算机辅助设计和有限元分析软件包中创建的。容器壁被认为是非线性各向异性材料，而流体被模拟为具有脉动流的牛顿流体。通过位移时间函数施加夹具。开发了完全耦合的双向固液相互作用模型。结果发现，夹具设计显着影响血管壁的应力。具有突出特征的夹具使整体 Von Mises 应力增加了约 60%，压缩应力增加了 200% 以上。有趣的是，当应用突出夹时，动脉壁管腔（内皮）侧的 Von Mises 应力约为外壁的两倍。该比值远高于板状夹具的约1.3。在夹紧过程中演示了流动反转过程。在完全血管闭塞之前立即检测到振动、流动和壁剪切应力振荡。常用的突出夹具增加了血管壁的应力，特别是压应力。这种设计还显着增加了内皮的压力，不利于血管健康。目前的发现与手术夹设计以及内皮上的瞬时机械负荷和潜在损伤有关。变形和应力分析可以为交叉夹紧过程中组织损伤的模式提供有价值的见解。
Vascular cross-clamping is applied in many cardiovascular surgeries such as coronary bypass, aorta repair, and valve procedures. Experimental studies have found that clamping of various degrees caused damage to arteries. This study examines the effects of popular clamps on vessel wall. Models of the aorta and clamp were created in Computer Assisted Design and Finite Element Analysis packages. The vessel wall was considered as a non-linear anisotropic material while the fluid was simulated as Newtonian with pulsatile flow. The clamp was applied through displacement time function. Fully coupled two-way solid-fluid interaction models were developed. It was found that the clamp design significantly affected the stresses in vessel wall. The clamp with a protrusion feature increased the overall Von Mises stress by about 60% and the compressive stress by more than 200%. Interestingly, when the protrusion clamp was applied, the Von Mises stress at the lumen (endothelium) side of artery wall was about twice that of the outer wall. This ratio was much higher than that of the plate-like clamp which was about 1.3. The flow reversal process was demonstrated during clamping. Vibrations, flow and wall shear stress oscillations were detected immediately before total vessel occlusion. The commonly used protrusion clamp increased stresses in vessel wall, especially the compressive stress. This design also significantly increased the stresses on endothelium, detrimental to vessel health. The present findings are relevant to surgical clamp design as well as the transient mechanical loading on the endothelium and potential injury. The deformation and stress analysis may provide valuable insights into the mode of tissue injury during cross-clamping.
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影响因子：
3
作者：
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通讯作者：
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