北京生物医学工程

具不同狭窄-吻合口位置关系的冠状动脉搭桥术的血流动力学仿真分析

Hemodynamic simulation of CABG with different distances between stenosis and anastomosis

作者：王枫刘有军丁金立

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）：2013·33·6（551-558）

摘要：

目的通过有限元仿真探索带有辅助搭桥血管模式的冠状动脉搭桥术中,辅助搭桥管吻合口与冠状动脉狭窄处之间的距离对该吻合口及其下游区域的血流动力学影响，为带有辅助搭桥管的新型冠状动脉搭桥术的临床应用提供理论指导。方法利用有限元分析方法，假定血液为不可压缩牛顿流体，建立3种搭桥血管模型，其冠状动脉上吻合口和狭窄的距离分别为0.0045m、0.006m和0.009m。通过仿真结果考察不同模型中的血流速度、壁面切应力等参数的变化。结果吻合口与狭窄处之间的距离不同，冠状动脉血管内的血流动力学参数也不相同。速度方面，心动周期0.09s时刻L1.5模型中吻合口足跟处轴向截面的最大速度约为0.54m/s，同时刻L2和L3模型中其最大速度分别为0.45m/s和0.37m/s。壁面切应力方面，0.09s时刻，L1.5模型中吻合口对应面的血管壁上其流动停滞点距离吻合口足跟仅为0.0024m，同时刻L2和L3模型中其流动停滞点距离足跟处分别为0.0039m和0.0068m，长度明显增加。其他时刻流动停滞点分布有相同趋势。结论在实施冠状动脉搭桥术时，吻合口与狭窄处之间保持较大的距离，有利于改善吻合口处的血流动力学环境，降低吻合口处发生再狭窄的可能性。

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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