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迈向最佳血流动力学:Fontan循环的计算机建模

Toward optimal hemodynamics: computer modeling of the Fontan circuit.

作者信息

Bove E L, de Leval M R, Migliavacca F, Balossino R, Dubini G

机构信息

Department of Surgery, Section of Cardiac Surgery, University of Michigan School of Medicine, Ann Arbor, MI 48109, USA.

出版信息

Pediatr Cardiol. 2007 Nov-Dec;28(6):477-81. doi: 10.1007/s00246-007-9009-y.

DOI:10.1007/s00246-007-9009-y
PMID:17763891
Abstract

The construction of efficient designs with minimal energy losses is especially important for cavopulmonary connections. The science of computational fluid dynamics has been increasingly used to study the hemodynamic performance of surgical operations. Three-dimensional computer models can be accurately constructed of typical cavopulmonary connections used in clinical practice based on anatomic data derived from magnetic resonance scans, angiocardiograms, and echocardiograms. Using these methods, the hydraulic performance of the hemi-Fontan, bidirectional Glenn, and a variety of types of completion Fontan operations can be evaluated and compared. This methodology has resulted in improved understanding and design of these surgical operations.

摘要

构建具有最小能量损失的高效设计对于腔肺连接尤为重要。计算流体动力学科学已越来越多地用于研究外科手术的血流动力学性能。基于磁共振扫描、心血管造影和超声心动图获得的解剖数据,可以精确构建临床实践中使用的典型腔肺连接的三维计算机模型。使用这些方法,可以评估和比较半Fontan手术、双向Glenn手术以及各种类型的完全Fontan手术的水力性能。这种方法有助于更好地理解和设计这些外科手术。

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Front Bioeng Biotechnol. 2025 Aug 15;13:1626645. doi: 10.3389/fbioe.2025.1626645. eCollection 2025.
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Differences in Exercise Performance in Fontan Patients with Extracardiac Conduit and Lateral Tunnel: A FORCE Fontan Registry Study.心外管道与侧隧道式Fontan手术患者运动能力的差异:FORCE Fontan注册研究
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How cardiac output is controlled in a Fontan circulation: an update.

本文引用的文献

1
Computational fluid dynamics simulations in realistic 3-D geometries of the total cavopulmonary anastomosis: the influence of the inferior caval anastomosis.全腔静脉肺动脉吻合术真实三维几何结构中的计算流体动力学模拟:下腔静脉吻合术的影响
J Biomech Eng. 2003 Dec;125(6):805-13. doi: 10.1115/1.1632523.
2
Computational fluid dynamics in the evaluation of hemodynamic performance of cavopulmonary connections after the Norwood procedure for hypoplastic left heart syndrome.计算流体动力学在左心发育不全综合征诺伍德手术后腔肺连接血流动力学性能评估中的应用
J Thorac Cardiovasc Surg. 2003 Oct;126(4):1040-7. doi: 10.1016/s0022-5223(03)00698-6.
3
在Fontan循环中的心输出量是如何控制的:最新进展
Interdiscip Cardiovasc Thorac Surg. 2025 Feb 5;40(2). doi: 10.1093/icvts/ivae183.
4
Impact of Age-Related Change in Caval Flow Ratio on Hepatic Flow Distribution in the Fontan Circulation.年龄相关的腔静脉血流比例变化对腔静脉循环中肝血流分布的影响。
Circ Cardiovasc Imaging. 2024 Apr;17(4):e016104. doi: 10.1161/CIRCIMAGING.123.016104. Epub 2024 Apr 3.
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In vitro hemodynamic performance of a blood pump for self-powered venous assist in univentricular hearts.用于单心室自体静脉辅助的血泵的体外血液动力学性能。
Sci Rep. 2024 Mar 23;14(1):6941. doi: 10.1038/s41598-024-57269-7.
6
Hemi-Fontan and bidirectional Glenn operations result in flow-mediated viscous energy loss at the time of stage II palliation.半Fontan手术和双向Glenn手术在二期姑息治疗时会导致血流介导的粘性能量损失。
JTCVS Open. 2023 Sep 30;16:836-843. doi: 10.1016/j.xjon.2023.09.030. eCollection 2023 Dec.
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A computational study of aortic reconstruction in single ventricle patients.单心室患者主动脉重建的计算研究。
Biomech Model Mechanobiol. 2023 Feb;22(1):357-377. doi: 10.1007/s10237-022-01650-w. Epub 2022 Nov 5.
8
Late Fontan Circulatory Failure. What Drives Systemic Venous Congestion and Low Cardiac Output in Adult Fontan Patients?晚期Fontan循环衰竭。是什么导致成人Fontan患者出现体循环静脉淤血和心输出量降低?
Front Cardiovasc Med. 2022 Mar 14;9:825472. doi: 10.3389/fcvm.2022.825472. eCollection 2022.
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Parametric investigation of an injection-jet self-powered Fontan circulation.注射射流自供能法乐氏四联症循环的参数研究。
Sci Rep. 2022 Feb 9;12(1):2161. doi: 10.1038/s41598-022-05985-3.
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On the Periodicity of Cardiovascular Fluid Dynamics Simulations.心血管流体动力学模拟的周期性。
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Influence of connection geometry and SVC-IVC flow rate ratio on flow structures within the total cavopulmonary connection: a numerical study.
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Effects of pulmonary afterload on the hemodynamics after the hemi-Fontan procedure.
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In vivo flow dynamics of the total cavopulmonary connection from three-dimensional multislice magnetic resonance imaging.三维多层磁共振成像对全腔静脉肺动脉连接术的体内血流动力学研究
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