Vascular thrombosis during support with continuous flow ventricular assist devices: correlation with computerized flow simulations.
Vascular thrombosis during support with continuous flow ventricular assist devices: correlation with computerized flow simulations.
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DOI：
10.1111/j.1527-5299.2005.04474.x
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发表时间：
2005-07-01
期刊：
影响因子：
--
通讯作者：
Harting, Matthew T
中科院分区：
文献类型：
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作者：
Kar, Biswajit;Delgado, Reynolds M 3rd;Harting, Matthew T
连续流泵越来越多地用于治疗严重心力衰竭。这些泵通过降低动脉循环中的搏动来改变流动生理学。对于外周狭窄的患者，连续流动泵可能导致外周血管血栓形成，可能在非限流性狭窄区域诱发血管血栓形成。作者进行了计算机血流建模模拟，以分析狭窄区域血流动力学改变的影响。根据之前的临床经验，我们对颈总动脉的狭窄区域进行了建模。计算机血流模型显示，在非脉动血流期间，邻近狭窄区域的血液停滞区域具有低剪切应力和低速度。在脉动流期间不存在这种停滞。这些结果表明，生理血流改变可能会加速已有狭窄患者的动脉导管闭塞。这一发现对于患有外周血管疾病且使用连续流装置的患者可能很重要；因此，有必要进一步研究。
Continuous flow pumps are increasingly used to treat severe heart failure. These pumps alter flow physiology by lowering pulsatility in the arterial circulation. In patients with peripheral stenosis, continuous flow pumps may lead to thrombosis of peripheral vessels, possibly predisposing to vascular thrombosis in areas of non-flow-limiting stenosis. The authors performed a computerized flow modeling simulation to analyze the effects of altered hemodynamics in a stenotic area. Drawing on previous clinical experience, we modeled a stenotic area in the common carotid artery. Computerized flow modeling revealed blood stagnation zones with low shear stress and velocity adjacent to the stenotic area during nonpulsatile flow. Such stagnation was not present during pulsatile flow. These results indicate a mechanism by which altered physiologic flow may accelerate occlusion of arterial conduits in patients with preexisting stenosis. This finding may be important for patients with continuous flow devices who have peripheral vascular disease; therefore, further study is warranted.