Berdajs Denis A, Mosbahi Selim, Charbonnier Dominique, Hullin Roger, von Segesser Ludwig K
Department of Surgery and Anesthesiology, Cardiovascular Research, University Hospital Lausanne, Lausanne, Switzerland.
Department of Surgery and Anesthesiology, Cardiovascular Research, University Hospital Lausanne, Lausanne, Switzerland.
J Surg Res. 2015 Jul;197(1):50-7. doi: 10.1016/j.jss.2015.03.001. Epub 2015 Mar 14.
The mechanism behind early graft failure after right ventricular outflow tract (RVOT) reconstruction is not fully understood. Our aim was to establish a three-dimensional computational fluid dynamics (CFD) model of RVOT to investigate the hemodynamic conditions that may trigger the development of intimal hyperplasia and arteriosclerosis.
Pressure, flow, and diameter at the RVOT, pulmonary artery (PA), bifurcation of the PA, and left and right PAs were measured in 10 normal pigs with a mean weight of 24.8 ± 0.78 kg. Data obtained from the experimental scenario were used for CFD simulation of pressure, flow, and shear stress profile from the RVOT to the left and right PAs.
Using experimental data, a CFD model was obtained for 2.0 and 2.5-L/min pulsatile inflow profiles. In both velocity profiles, time and space averaged in the low-shear stress profile range from 0-6.0 Pa at the pulmonary trunk, its bifurcation, and at the openings of both PAs. These low-shear stress areas were accompanied to high-pressure regions 14.0-20.0 mm Hg (1866.2-2666 Pa). Flow analysis revealed a turbulent flow at the PA bifurcation and ostia of both PAs.
Identified local low-shear stress, high pressure, and turbulent flow correspond to a well-defined trigger pattern for the development of intimal hyperplasia and arteriosclerosis. As such, this real-time three-dimensional CFD model may in the future serve as a tool for the planning of RVOT reconstruction, its analysis, and prediction of outcome.
右心室流出道（RVOT）重建术后早期移植物失败的机制尚未完全明确。我们的目的是建立一个RVOT的三维计算流体动力学（CFD）模型，以研究可能引发内膜增生和动脉硬化发展的血流动力学状况。
对10只平均体重为24.8±0.78 kg的正常猪测量RVOT、肺动脉（PA）、PA分叉处以及左右肺动脉的压力、流量和直径。将从实验场景中获得的数据用于从RVOT到左右肺动脉的压力、流量和剪切应力分布的CFD模拟。
利用实验数据，获得了2.0和2.5 L/min脉动流入分布的CFD模型。在这两种速度分布中，肺动脉干、其分叉处以及左右肺动脉开口处低剪切应力分布范围内的时间和空间平均值为0 - 6.0 Pa。这些低剪切应力区域伴随着14.0 - 20.0 mmHg（1866.2 - 2666 Pa）的高压区域。血流分析显示在PA分叉处和左右肺动脉开口处存在湍流。
确定的局部低剪切应力、高压和湍流对应于内膜增生和动脉硬化发展的明确触发模式。因此，这种实时三维CFD模型未来可能作为RVOT重建规划、分析和结果预测的工具。
