Laboratory of Biological Structure Mechanics, Structural Engineering Department, Politecnico di Milano, Milan, Italy.
J Biomech. 2011 Feb 24;44(4):767-70. doi: 10.1016/j.jbiomech.2010.11.001. Epub 2010 Nov 18.
A less-invasive procedure that combines interventional stent placement in the ductus arteriosus and surgical banding of the branch pulmonary arteries has been recently introduced in the treatment of the hypoplastic left heart syndrome (HLHS). The hemodynamic behaviour of this hybrid approach has not been examined before in a mathematical model. In this study, a mathematical model of the hybrid procedure for HLHS is described, applying a multiscale approach that couples 3D models of the area of the surgical operation and lumped parameter models of the remaining circulation. The effects of various degrees of pulmonary banding and different stent sizes inserted in the ductus arteriosus on pulmonary-systemic flow ratio, cardiac output and oxygen delivery were assessed. Computational results suggest that balanced systemic and pulmonary blood flow and optimal systemic oxygen delivery are sensitive to the degree of pulmonary arterial banding and not to the size of the ductal stent.
一种将介入性动脉导管支架置入术和肺动脉分支环扎术相结合的微创治疗方法最近被引入到左心发育不全综合征（HLHS）的治疗中。这种混合治疗方法的血流动力学行为在数学模型中尚未被研究过。在本研究中，描述了一种用于 HLHS 的混合手术的数学模型，采用一种多尺度方法，将手术区域的 3D 模型与剩余循环的集中参数模型耦合。评估了不同程度的肺动脉环扎术和在动脉导管中插入的不同支架尺寸对肺-体循环血流比、心输出量和氧输送的影响。计算结果表明，体循环和肺循环血流的平衡以及全身氧输送的最佳状态对肺动脉环扎术的程度敏感，而与导管支架的大小无关。
