北京生物医学工程

TOF个性化手术规划的血流动力学模拟

Hemodynamics Simulation of Patient-Specific Surgical Planning For TOF

作者：柴霖娟丁金立曹雪刘荣黎刘有军

单位：北京工业大学生命科学与生物工程学院（北京100124）

分类号：

出版年·卷·期（页码）：2010·29·6（556-560）

摘要：

目的法洛四联症(tetralogy of Fallot,TOF)是出现在新生儿中一种常见的先天性心脏病，其初期治疗的关键是在主动脉和肺动脉之间建立人工侧支循环，本研究从血流动力学角度探讨升主动脉与右肺动脉吻合的手术方案对TOF治疗的有效性。方法采用计算流体力学的方法对TOF手术模型进行数值模拟，重点考察搭桥管径对手术效果的影响，并根据增流率、分流率、能量损失、压力分布、壁面切应力分布等血流动力学参数对手术方案进行评价。结果实施搭桥手术后，左、右肺动脉出口的血流量有不同程度的增加。结论升主动脉与右肺动脉吻合的搭桥方案，可以在一定程度上缓解肺动脉狭窄造成的血流供给不足。

Objective Tetralogy of Fallot (TOF) is one of the most common complex congenital heart diseases in newborns. For the TOF patient, it is vital to establish a shunt between the pulmonary and systemic circulations. The objective of this study is to investigate the therapy efficacy of TOF with the chosen surgical plan, shunt of ascending aorta and the right pulmonary artery, from the hemodynamic point of view. Methods While we numerically simulated the surgical models with computational fluid dynamics (CFD) approaches, we highlighted the influence of shunt diameter on surgical effect and assessed the surgery option from the hemodynamic parameters, such as flow rate increased, flow split, power loss, pressure, and wall shear stress. Results The blood flow rates in both left and right pulmonary arteries obtained a different degree of increase after the operation. Conclusion The surgical plan, shunt of ascending aorta and the right pulmonary arteries, could alleviate the blood deficiency caused by pulmonary artery stenosis.

参考文献：

［1］张铁钧. 法乐氏四联症及外科治疗［J］. 辽宁医学杂志, 2001, 5(2): 93-94.
［2］丁文祥, 苏肇伉. 小儿心脏外科学［M］. 青岛:山东科学技术出版社, 2000.
［3］Francesco Migliavacca, Rossella Balossino, Giancarlo Pennati, et al. Multiscale modelling in biofluidynamics: Application to reconstructive paediatric cardiac surgery［J］. Journal of Biomechanics, 2006, 39: 1010-1020.
［4］Kassab GS, Navia JA. Biomechanical considerations in the design of graft: the homeostasis hypothesis［J］. Annual Review of Biomedical Engineering, 2006, 8: 499-535.
［5］Kerem Pekkan, Onur Dur, Kirk Kanter, et al. Neonatal aortic arch hemodynamics and perfusion during cardiopulmonary bypass［J］. Journal of Biomedical Engineering, 2008, 130: 1-13.
［6］Francesco Migliavacca, Gabriele Dubini, Giancarlo Pennati, et al. Computational model of the fluid dynamics in systemic-to-pulmonary shunts［J］. Journal of Biomechanics, 2000, 33: 549-557.
［7］Bove EL, de Leval MR, Migliavacca F, et al. Computational fluid dynamics in the evaluation of hemodynamic performance of cavopulmonary connections after the Norwood procedure for hypoplastic left heart syndrome［J］. The Journal of Thoracic and Cardiovascular Surgery, 2003, 126: 1040-1047.
［8］Shahcheraghi N, Dwyer HA, Cheer AY, et al. Unsteady and Three-Dimensional simulation of blood flow in the Human Aortic Arch［J］. Journal of Biomechanical Engineering, 2002, 124: 378-387.
［9］万大伟, 孙琦, 刘应征,等. 双侧双向Glenn手术的全三维血流动力学数值分析［J］. 生物医学工程研究, 2008, 27(2): 79-83
［10］Chern MJ, Wu MT, Wang HL. Numerical investigation of regurgitation phenomena in pulmonary arteries of Tetralogy of Fallot patients after repair［J］. Journal of Biomechanics, 2008, 41: 3002-3009.
［11］Kerem P, Brian W, Kirk K, et al. Patient-specific surgical planning and hemodynamic computational fluid dynamics optimization through free-form haptic anatomy editing tool (SURGEM)［J］. Med Biol Eng Comput,2008，46:1139-1152.

服务与反馈：

【文章下载】【加入收藏】

提示：您还未登录，请登录！点此登录