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针对特定患者的B型主动脉夹层,对由夹层瓣分隔的真腔和假腔内血流动力学特征的评估。

An Assessment of the Haemodynamic Features Occurring Within the True and False Lumens Separated by a Dissection Flap for a Patient-Specific Type B Aortic Dissection.

作者信息

Morris Liam, Tierney Paul, Hynes Niamh, Sultan Sherif

机构信息

Galway-Mayo Institute of Technology, Galway, Ireland.

Galway Medical Technology Centre, Department of Mechanical and Industrial Engineering, Galway-Mayo Institute of Technology, Galway, Ireland.

出版信息

Front Cardiovasc Med. 2022 Mar 17;9:797829. doi: 10.3389/fcvm.2022.797829. eCollection 2022.

Abstract

One of the highest mortality rates of cardiovascular diseases is aortic dissections with challenging treatment options. Currently, less study has been conducted in developing patient-specific Type B aortic dissection models, which mimic physiological flow conditions along the true and false lumens separated by a dissection flap with multiple entry and exit tears. A patient-specific Stanford Type B aortic dissection scan was replicated by an in-house manufactured automatic injection moulding system and a novel modelling technique for creating the ascending aorta, aortic arch, and descending aorta incorporating arterial branching, the true/false lumens, and dissection flap with entry and exit intimal tears. The physiological flowrates and pressure values were monitored, which identified jet stream fluid flows entering and exiting the dissection tears. Pressure in the aorta's true lumen region was controlled at 125/85 mmHg for systolic and diastolic values. Pressure values were obtained in eight sections along the false lumen using a pressure transducer. The true lumen systolic pressure varied from 122 to 128 mmHg along the length. Flow patterns were monitored by ultrasound along 12 sections. Detailed images obtained from the ultrasound transducer probe showed varied flow patterns with one or multiple jet steam vortices along the aorta model. The dissection flap movement was assessed at four sections of the patient-specific aorta model. The displacement values of the flap varied from 0.5 to 3 mm along the model. This model provides a unique insight into aortic dissection flow patterns and pressure distributions. This dissection phantom model can be used to assess various treatment options based on the surgical, endovascular, or hybrid techniques.

摘要

心血管疾病中死亡率最高的病症之一是主动脉夹层,其治疗方案具有挑战性。目前,在开发模拟生理血流状况的患者特异性B型主动脉夹层模型方面的研究较少,该模型可模拟由带有多个入口和出口撕裂的夹层瓣分隔的真腔和假腔内的生理血流状况。通过内部制造的自动注射成型系统和一种新颖的建模技术复制了患者特异性斯坦福B型主动脉夹层扫描,以创建包含动脉分支、真/假腔以及带有入口和出口内膜撕裂的夹层瓣的升主动脉、主动脉弓和降主动脉。监测了生理流速和压力值,确定了进出夹层撕裂处的射流流体流动。主动脉真腔区域的压力在收缩压和舒张压时分别控制在125/85 mmHg。使用压力传感器在沿假腔的八个截面处获取压力值。真腔收缩压沿长度方向在122至128 mmHg之间变化。通过超声在12个截面处监测血流模式。从超声换能器探头获得的详细图像显示,沿主动脉模型存在一个或多个射流蒸汽涡旋的不同血流模式。在患者特异性主动脉模型的四个截面处评估夹层瓣的运动。沿模型夹层瓣的位移值在0.5至3 mm之间变化。该模型为主动脉夹层血流模式和压力分布提供了独特的见解。这种夹层模型可用于评估基于外科、血管内或混合技术的各种治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac66/8968342/e90a729ba8cb/fcvm-09-797829-g001.jpg

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