HEMODYNAMIC EFFECTS OF THE ANASTOMOSES IN THE MODIFIED BLALOCK-TAUSSIG SHUNT: A NUMERICAL STUDY USING A 0D/3D COUPLING METHOD
HEMODYNAMIC EFFECTS OF THE ANASTOMOSES IN THE MODIFIED BLALOCK-TAUSSIG SHUNT: A NUMERICAL STUDY USING A 0D/3D COUPLING METHOD
复制标题
改良 BLALOCK-TAUSSIG 分流术中吻合的血流动力学效应：使用 0D/3D 耦合方法的数值研究
DOI：
10.1142/s0219519415500177
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发表时间：
2015-02-01
影响因子：
0.8
通讯作者：
Qiao, Aike
中科院分区：
文献类型：
--
作者：
Zhao, Xi;Liu, Youjun;Qiao, Aike
改良的Blalock-Taussig （BT）分流术是一种姑息性手术，可以通过介入全身到肺动脉分流术来帮助法洛四联症（TOF）患者提高血氧饱和度。临床上常用的吻合方式有两种：端侧吻合（ETS）和侧侧吻合（STS）。本文研究了改良BT分流术中吻合口形状对血流动力学的影响。重建了3个吻合口形状不同的模型。第一个模型采用ETS吻合器。对于第二种模型的无名动脉（IA）和肺动脉（PA），分别采用ETS和STS吻合。最后，将STS吻合器应用于第三个模型。采用0D/3D耦合方法，将三维（3D）动脉模型与零维（0D）集总参数模型耦合，对心血管系统进行数值模拟。模拟结果显示，模型1左、右PA灌注不平衡。模型3的分流出现旋流，但模型3的分流流量较低。ETS吻合术可能导致左、右心室血流灌注不平衡。相反，STS吻合可以使血液灌注更加平衡。否则，在IA处的STS吻合术会在分流管内产生旋流，在减少肺灌注的同时提供更好的血流动力学环境。
The modified Blalock-Taussig (BT) shunt is a palliative surgery which can help the tetralogy of Fallot (TOF) patient increase the blood oxygen saturation by interposing a systemic-to-pulmonary artery shunt. Two typical anastomotic shapes are frequently used in clinical practice: the end-to-side (ETS) and the side-to-side (STS) anastomosis. This paper examines the hemodynamic influence of the anastomotic shape in the modified BT shunt. Three models with different anastomotic shapes were reconstructed. The ETS anastomoses were applied in the first model. For the innominate artery (IA) and the pulmonary artery (PA) in the second model, the ETS and the STS anastomosis were applied, respectively. Finally, the STS anastomoses were applied in the third model. The 0D/3D coupling method was used to perform a numerical simulation by coupling the three-dimensional (3D) artery model with a zero-dimensional (0D) lumped parameter model for the cardiovascular system. The simulation results showed that the perfusion into the left and right PA in Model 1 was unbalanced. Swirling flow appeared in the shunt in Model 3, but the shunt flow rate in Model 3 was lower. The ETS anastomosis at the PA may cause unbalanced blood perfusion into the left and right PA. Conversely, the STS anastomosis can make the blood perfusion more balanced. Otherwise,the STS anastomosis at the IA could generate a swirling flow in the shunt which may provide a better hemodynamic environment while decreasing the pulmonary perfusion.