Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Switzerland.
J Thorac Cardiovasc Surg. 2010 Jun;139(6):1602-8. doi: 10.1016/j.jtcvs.2009.09.023. Epub 2009 Nov 12.
The Cabrol procedure is characterized by insertion of an ascending aortic composite graft with reimplantation of the coronary arteries by the interposition of a graft tube. Our purpose is to report the clinical long-term follow-up and computed tomographic findings in patients having undergone the Cabrol procedure and to determine blood flow in the Cabrol graft using computational fluid dynamics.
Clinical follow-up (76.6 +/- 16.6 months) and dual-source computed tomographic angiography data of 7 patients (all men, mean age 54.9 +/- 9.6 years) with 12 Cabrol grafts (left main coronary artery, n = 7; right coronary artery, n = 5) were reviewed. In 2 patients, the right coronary artery was directly reattached to the aortic graft. Computational fluid dynamics were calculated using computed tomographic data of a patient with the Cabrol procedure and compared with those in a Valsalva graft and a healthy aortic root.
Computed tomography showed Cabrol graft occlusions to 1 of 7 (14%) left main and of 2 of 5 (40%) right coronary arteries. Six grafts to the left main and 3 to the right coronary artery were fully patent, similar to the 2 directly reattached right coronary arteries to the aortic graft. Computational fluid dynamics results show similar blood flow parameters into the coronaries for the healthy aortic root and Valsalva graft. In the Cabrol graft, a spiraling flow pattern with low flow into the right coronary artery was found (right coronary artery = 1 mL/min at both systole and diastole).
Our study indicates low flow rates particularly in the right Cabrol graft correlating with a higher incidence of occlusions of the right as compared with the left Cabrol graft at long-term follow-up.
Cabrol 手术的特点是插入升主动脉复合移植物，并通过移植物管插入冠状动脉再移植。我们的目的是报告接受 Cabrol 手术的患者的临床长期随访和计算机断层扫描结果，并使用计算流体动力学确定 Cabrol 移植物中的血流。
对 7 例（均为男性，平均年龄 54.9 +/- 9.6 岁）12 个 Cabrol 移植物（左主干冠状动脉，n = 7；右冠状动脉，n = 5）的临床随访（76.6 +/- 16.6 个月）和双源计算机断层扫描血管造影数据进行了回顾性分析。在 2 例患者中，右冠状动脉直接重新连接到主动脉移植物。使用接受 Cabrol 手术的患者的计算机断层扫描数据计算计算流体动力学，并将其与 Valsalva 移植物和健康主动脉根部的计算流体动力学进行比较。
计算机断层扫描显示，7 例左主干中有 1 例（14%）和 5 例右冠状动脉中有 2 例（40%）出现 Cabrol 移植物闭塞。6 个左主干移植物和 3 个右冠状动脉移植物完全通畅，与直接重新连接到主动脉移植物的 2 个右冠状动脉相似。计算流体动力学结果显示，健康主动脉根部和 Valsalva 移植物的冠状动脉血流参数相似。在 Cabrol 移植物中，发现了一种螺旋血流模式，导致右冠状动脉血流较低（右冠状动脉在收缩期和舒张期均为 1 毫升/分钟）。
我们的研究表明，特别是在右 Cabrol 移植物中，血流速度较低，与长期随访中右 Cabrol 移植物闭塞的发生率高于左 Cabrol 移植物相关。
