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具不同狹窄-吻合口位置關(guān)系的冠狀動(dòng)脈搭橋術(shù)的血流動(dòng)力學(xué)仿真分析

Hemodynamic simulation of CABG with different distances between stenosis and anastomosis

作者: 王楓  劉有軍  丁金立 
單位:北京工業(yè)大學(xué)生命科學(xué)與生物工程學(xué)院(北京100124)
關(guān)鍵詞: 冠狀動(dòng)脈搭橋;血流動(dòng)力學(xué);壁面切應(yīng)力;計(jì)算流體力學(xué) 
分類號(hào):
出版年·卷·期(頁碼):2013·33·6(551-558)
摘要:

目的 通過有限元仿真探索帶有輔助搭橋血管模式的冠狀動(dòng)脈搭橋術(shù)中,輔助搭橋管吻合口與冠狀動(dòng)脈狹窄處之間的距離對(duì)該吻合口及其下游區(qū)域的血流動(dòng)力學(xué)影響,為帶有輔助搭橋管的新型冠狀動(dòng)脈搭橋術(shù)的臨床應(yīng)用提供理論指導(dǎo)。方法 利用有限元分析方法,假定血液為不可壓縮牛頓流體,建立3種搭橋血管模型,其冠狀動(dòng)脈上吻合口和狹窄的距離分別為0.0045m、0.006m和0.009m。通過仿真結(jié)果考察不同模型中的血流速度、壁面切應(yīng)力等參數(shù)的變化。結(jié)果 吻合口與狹窄處之間的距離不同,冠狀動(dòng)脈血管內(nèi)的血流動(dòng)力學(xué)參數(shù)也不相同。速度方面,心動(dòng)周期0.09s時(shí)刻L1.5模型中吻合口足跟處軸向截面的最大速度約為0.54m/s,同時(shí)刻L2和L3模型中其最大速度分別為0.45m/s和0.37m/s。壁面切應(yīng)力方面,0.09s時(shí)刻,L1.5模型中吻合口對(duì)應(yīng)面的血管壁上其流動(dòng)停滯點(diǎn)距離吻合口足跟僅為0.0024m,同時(shí)刻L2和L3模型中其流動(dòng)停滯點(diǎn)距離足跟處分別為0.0039m和0.0068m,長(zhǎng)度明顯增加。其他時(shí)刻流動(dòng)停滯點(diǎn)分布有相同趨勢(shì)。結(jié)論 在實(shí)施冠狀動(dòng)脈搭橋術(shù)時(shí),吻合口與狹窄處之間保持較大的距離,有利于改善吻合口處的血流動(dòng)力學(xué)環(huán)境,降低吻合口處發(fā)生再狹窄的可能性。

Objective To research the effect of the distance between stenosis and anastomosis on the hemodynamics of the coronary anastomosis,which may provide some theoretical guidance for the clinic treatment. Methods Three models with different distances between stenosis and anastomosis are made and analyzed by finite element analysis,and the distances are 0.0045m,0.006m and 0.009m respectively. Results The hemodynamic parameter in coronary artery changes as long as the distance between stenosis and anastomosis changes. At time of 0.09s,the maximum velocities of the cross section near the anastomosis are 0.54m/s,0.45m/s and 0.37m/s corresponding to model L1.5,L2 and L3. At the same time,the distances between stagnation and anastomosis on the lower wall are 0.0024m,0.0039m and 0.0068m corresponding to model L1.5,L2 and L3. Conclusions Keeping a big distance between the stagnation and anastomosis is helpful for the hemodynamic environment of anastomosis.

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