Influence of Geometric Changes in the Thoracic Aorta due to Arterial Switch Operations on the Wall Shear Stress Distribution
Influence of Geometric Changes in the Thoracic Aorta due to Arterial Switch Operations on the Wall Shear Stress Distribution
复制标题
动脉转接手术引起的胸主动脉几何变化对壁剪应力分布的影响
DOI：
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发表时间：
2017
影响因子：
--
通讯作者：
K. Morinishi
中科院分区：
文献类型：
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作者：
T. Fukui;Hiroaki Asama;M. Kimura;T. Itoi;K. Morinishi
背景：大动脉转位（TGA）是最严重的先天性心脏病之一。大动脉调转术是治疗TGA的首选术式。尽管许多报告显示ASO术后效果良好，但一些患者在手术后会出现循环系统问题。ASO后出现问题的一个原因是胸主动脉的曲率和扭转的局部变化。目的：需要详细研究这些几何变化对血流场的影响，以考虑阿索后可能的心血管问题。方法：在本研究中，我们在ASO后的胸主动脉中进行血流模拟，根据曲率和扭转评价由于阿索引起的主动脉几何变化，并考虑几何变化对主动脉血流的影响。结果：发现主动脉根部附近的大曲率导致收缩中期最大壁面切应力值增加。此外，大扭矩导致最大壁面剪应力区域的周向变化。实验还发现，ASO后模型的最大壁面切应力明显高于正常模型。这表明ASO后动脉的主动脉瘤发生风险可能高于正常动脉。结论：为降低主动脉瓣狭窄的发生率，建议在阿索动脉瓣关闭术中减少主动脉根部附近的曲率。
Background: The transposition of the great arteries (TGA) is one of the most severe congenital heart diseases. The arterial switch operation (ASO) is the preferred procedure to treat TGA. Although numerous reports have shown good results after ASOs, some patients suffer from circulatory system problems following the procedure. One reason for problems post-ASO is the local changes in the curvature and torsion of the thoracic aorta. Objective: The influence of these geometric changes on the blood flow field needs to be investigated in detail to consider possible cardiovascular problems after an ASO. Method: In this study, we conduct blood flow simulations in the thoracic aorta post-ASO, evaluate geometric changes in the aorta due to the ASO in terms of curvature and torsion, and consider the effect of geometric changes on blood flow in the aorta. Results: It was found that a large curvature near the aortic root causes an increase in the maximal wall shear stress value in the middle systole. Moreover, a large torsion results in a circumferential change in the maximal wall shear stress region. It was also found that the maximal wall shear stress in the post-ASO models is significantly higher than that in the normal models. This indicates that the aortic aneurysm initiation risk for a post-ASO artery may be higher than that of a normal artery. Conclusion: To reduce the risk of initiating an aneurism, it is suggested that the curvature near the aortic root should be decreased during the ASO.
具有二尖瓣和三尖瓣主动脉瓣的升胸主动脉瘤血流动力学和壁应力的差异。
影响因子：
2.4
作者：
Pasta S;Rinaudo A;Luca A;Pilato M;Scardulla C;Gleason TG;Vorp DA
通讯作者：
Vorp DA
影响因子：
4.3
作者：
Fillinger, MF;Raghavan, ML;Kennedy, FE
通讯作者：
Kennedy, FE
影响因子：
56.9
作者：
FRANGOS, JA;ESKIN, SG;IVES, CL
通讯作者：
IVES, CL