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北京工业大学-II型心室辅助装置(VAD)的搏动支持模式对主动脉的血流动力学影响优于恒速模式:一项初步数值研究。

Pulsatile Support Mode of BJUT-II Ventricular Assist Device (VAD) has Better Hemodynamic Effects on the Aorta than Constant Speed Mode: A Primary Numerical Study.

作者信息

Gu Kaiyun, Gao Bin, Chang Yu, Zeng Yi

机构信息

School of Life Sciences and BioEngineering, Beijing University of Technology, Beijing, China (mainland).

School of Life Science and BioEngineering, Beijing University of Technology, Beijing, China (mainland).

出版信息

Med Sci Monit. 2016 Jul 1;22:2284-94. doi: 10.12659/msm.896291.

Abstract

BACKGROUND BJUT-II VAD is a novel left ventricular assist device (LVADs), directly implanted into the ascending aorta. The pulsatile support mode is proposed to achieve better unloading performance than constant speed mode. However, the hemodynamic effects of this support mode on the aorta are still unclear. The aim of this study was to clarify the hemodynamic effects BJUT-II VAD under pulsatile support mode on the aorta. MATERIAL AND METHODS Computational fluid dynamics (CFD) studies, based on a patient-specific aortic geometric model, were conducted. Wall shear stress (WSS), averaged WSS (avWSS), oscillatory shear index (OSI), and averaged helicity density (Ha) were calculated to compare the differences in hemodynamic effects between pulsatile support mode and constant speed mode. RESULTS The results show that avWSS under pulsatile support mode is significantly higher than that under constant speed mode (0.955Pa vs. 0.675Pa). Similarly, the OSI value under pulsatile mode is higher than that under constant speed mode (0.104 vs. 0.057). In addition, Ha under pulsatile mode for all selected cross-sections is larger than that under constant mode. CONCLUSIONS BJUT-II VAD, under pulsatile control mode, may prevent atherosclerosis lesions and aortic remodeling. The precise effects of pulsatile support mode on atherosclerosis and aortic remodeling need to be further studied in animal experiments.

摘要

背景

BJUT-II型心室辅助装置(LVAD)是一种新型的左心室辅助装置,直接植入升主动脉。提出脉动支持模式以实现比恒速模式更好的卸载性能。然而,这种支持模式对主动脉的血流动力学影响仍不清楚。本研究的目的是阐明BJUT-II型心室辅助装置在脉动支持模式下对主动脉的血流动力学影响。

材料与方法

基于患者特异性主动脉几何模型进行计算流体动力学(CFD)研究。计算壁面剪应力(WSS)、平均WSS(avWSS)、振荡剪切指数(OSI)和平均螺旋度密度(Ha),以比较脉动支持模式和恒速模式之间血流动力学影响的差异。

结果

结果表明,脉动支持模式下的avWSS显著高于恒速模式下的avWSS(0.955Pa对0.675Pa)。同样,脉动模式下的OSI值高于恒速模式下的OSI值(0.104对0.057)。此外,所有选定横截面在脉动模式下的Ha均大于恒速模式下的Ha。

结论

BJUT-II型心室辅助装置在脉动控制模式下可能预防动脉粥样硬化病变和主动脉重塑。脉动支持模式对动脉粥样硬化和主动脉重塑的确切影响需要在动物实验中进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cc5/4933548/e0e639a0c3bb/medscimonit-22-2284-g001.jpg

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