Plonek Tomasz, Rylski Bartosz, Dumanski Andrzej, Siedlaczek Przemyslaw, Kustrzycki Wojciech
Department of Cardiac Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
Heart Centre Freiburg University, Freiburg, Germany.
J Cardiothorac Surg. 2015 Aug 1;10:106. doi: 10.1186/s13019-015-0299-5.
External wrapping is a surgical method performed to prevent the dilatation of the aorta and to decrease the risk of its dissection and rupture. However, it is also believed to cause degeneration of the aortic wall. A biomechanical analysis was thus performed to assess the stress of the aortic wall subjected to external wrapping.
A stress analysis using the finite elements method was carried out on three models: a non-dilated aorta, a moderately dilated aorta and a wrapped aorta. The models were subjected to a pulsatile flow (120/80 mmHg) and a systolic aortic annulus motion of 11 mm.
The finite elements analysis showed that the stress exerted on the outer surface of the ascending aorta in the wrapping model (0.05-0.8 MPa) was similar to that observed in the normal aorta (0.03-0.7 MPa) and was lower than in the model of a moderately dilated aorta (0.06-1.4 MPa). The stress on the inner surface of the ascending aorta ranged from 0.2 MPa to 0.4 MPa in the model of the normal aorta, from 0.3 to 1.3 MPa in the model of the dilated aorta and from 0.05 MPa to 0.4 MPa in the wrapping model.
The results of this study suggest that the aortic wall is subjected to similar stress following a wrapping procedure to the one present in the normal aorta.
外部包裹术是一种用于预防主动脉扩张并降低其夹层和破裂风险的手术方法。然而,人们也认为它会导致主动脉壁退变。因此,进行了一项生物力学分析以评估接受外部包裹术的主动脉壁的应力。
对三个模型进行了使用有限元法的应力分析:一个未扩张的主动脉模型、一个中度扩张的主动脉模型和一个包裹后的主动脉模型。这些模型承受脉动血流(120/80 mmHg)以及主动脉瓣环11毫米的收缩期运动。
有限元分析表明,包裹模型中升主动脉外表面所受应力(0.05 - 0.8兆帕)与正常主动脉中观察到的应力(0.03 - 0.7兆帕)相似,且低于中度扩张主动脉模型中的应力(0.06 - 1.4兆帕)。正常主动脉模型中升主动脉内表面的应力范围为0.2兆帕至0.4兆帕,扩张主动脉模型中为0.3至1.3兆帕,包裹模型中为0.05兆帕至0.4兆帕。
本研究结果表明,主动脉壁在接受包裹术后所受应力与正常主动脉中的应力相似。