Tang T, Chiu I S, Chen H C, Cheng K Y, Chen S J
Department of Mechanical Engineering, Huafan University, Taipei, Taiwan.
J Thorac Cardiovasc Surg. 2001 Sep;122(3):529-34. doi: 10.1067/mtc.2001.115230.
The transposed great arteries are simply reversed by means of a conventional arterial switch operation with the Lecompte maneuver without resumption of their spiral relationship. We seek to clarify the functional implications of the spiral relationship of the great arteries by means of mathematic modeling.
Computational fluid dynamics is used to compare flow phenomena of the spiral and Lecompte (nonspiral) models under various body surface areas.
The velocity profile and wall-shear stress distribution are more uniform for the spiral than for the Lecompte model. The pressure drop and power loss ratio are smaller for the spiral than the Lecompte model for all the body surface areas investigated. The power loss ratio increases abruptly starting from 0.43 m2 of body surface area for the Lecompte model. At that specific stage, after arterial switch operation with the Lecompte maneuver, suprapulmonary stenoses occur most frequently.
Reconstructing the great arteries in spiral fashion might be recommended because the blood flow patterns are more streamlined than those of the Lecompte maneuver. Initiation of stenosis might be minimized to some extent.
通过采用 Lecompte 术式的传统动脉调转术，简单地反转转位的大动脉，而不恢复其螺旋关系。我们试图通过数学建模来阐明大动脉螺旋关系的功能意义。
采用计算流体动力学方法，比较螺旋模型和 Lecompte（非螺旋）模型在不同体表面积下的血流现象。
螺旋模型的速度剖面和壁面剪应力分布比 Lecompte 模型更均匀。在所研究的所有体表面积下，螺旋模型的压降和功率损失比均小于 Lecompte 模型。Lecompte 模型从体表面积 0.43 m² 开始，功率损失比急剧增加。在那个特定阶段，采用 Lecompte 术式进行动脉调转术后，肺上动脉狭窄最常发生。
建议以螺旋方式重建大动脉，因为其血流模式比 Lecompte 术式更流线型。狭窄的起始在一定程度上可能会最小化。
