Lim Jaekwan, Won Jong Yun, Ahn Chi Bum, Kim Jieon, Kim Hee Jung, Jung Jae Seung
Biomedical Research Center, Korea Testing Laboratory, Jinju, Korea.
Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Seoul, Korea.
J Chest Surg. 2021 Apr 5;54(2):81-87. doi: 10.5090/jcs.20.134.
Artificial grafts such as polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) are used for various cardiovascular surgical procedures. The compliance properties of prosthetic grafts could affect hemodynamic energy, which can be measured using the energy-equivalent pressure (EEP) and surplus hemodynamic energy (SHE). We investigated changes in the hemodynamic energy of prosthetic grafts.
In a simulation test, the changes in EEP for these grafts were estimated using COMSOL MULTIPHYSICS. The Young modulus, Poisson ratio, and density were used to analyze the grafts' material properties, and pre- and post-graft EEP values were obtained by computing the product of the pressure and velocity. In an study, Dacron and ePTFE grafts were anastomosed in an end-to-side fashion on the descending thoracic aorta of swine. The pulsatile pump flow was fixed at 2 L/min. Real-time flow and pressure were measured at the distal part of each graft, while clamping the other graft and the descending thoracic aorta. EEP and SHE were calculated and compared.
In the simulation test, the mean arterial pressure decreased by 39% for all simulations. EEP decreased by 42% for both grafts, and by around 55% for the native blood vessels after grafting. The test showed no significant difference between both grafts in terms of EEP and SHE.
The post-graft hemodynamic energy was not different between the Dacron and ePTFE grafts. Artificial grafts are less compliant than native blood vessels; however, they can deliver pulsatile blood flow and hemodynamic energy without any significant energy loss.
聚对苯二甲酸乙二酯(涤纶)和膨体聚四氟乙烯(ePTFE)等人工移植物用于各种心血管外科手术。人工血管移植物的顺应性特性可能会影响血流动力学能量,这可以使用能量等效压力(EEP)和剩余血流动力学能量(SHE)来测量。我们研究了人工血管移植物血流动力学能量的变化。
在模拟试验中,使用COMSOL MULTIPHYSICS估计这些移植物的EEP变化。杨氏模量、泊松比和密度用于分析移植物的材料特性,通过计算压力和速度的乘积获得移植物植入前后的EEP值。在一项研究中,涤纶和ePTFE移植物以端侧方式吻合在猪的降主动脉上。搏动泵流量固定为2 L/min。在夹住另一个移植物和降主动脉的同时,在每个移植物的远端测量实时流量和压力。计算并比较EEP和SHE。
在模拟试验中,所有模拟的平均动脉压下降了39%。两种移植物的EEP均下降了42%,植入后天然血管的EEP下降了约55%。试验表明,两种移植物在EEP和SHE方面没有显著差异。
涤纶和ePTFE移植物植入后的血流动力学能量没有差异。人工移植物的顺应性低于天然血管;然而,它们可以输送搏动性血流和血流动力学能量,而不会有任何明显的能量损失。