Department of Mechanical Engineering, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L7, Canada.
Institute of Biomedical Engineering, University of Toronto, Toronto, Canada.
Ann Biomed Eng. 2023 Jul;51(7):1420-1435. doi: 10.1007/s10439-023-03144-x. Epub 2023 Feb 1.
Tetralogy of Fallot (ToF) is characterized by stenosis causing partial obstruction of the right ventricular outflow tract, typically alleviated through the surgical application of a vessel patch made from a biocompatible material. In this study, we use computational simulations to compare the mechanical performance of four patch materials for various stenosis locations. Nine idealized pre-operative ToF geometries were created by imposing symmetrical stenoses on each of three anatomical sub-regions of the pulmonary arteries of three patients with previously repaired ToF. A virtual surgery methodology was implemented to replicate the steps of vessel de-pressurization, surgical patching, and subsequent vessel expansion after reperfusion. Significant differences in patch average stress (p < 0.001) were found between patch materials. Biological patch materials (porcine xenopericardium, human pericardium) exhibited higher patch stresses in comparison to synthetic patch materials (Dacron and PTFE). Observed differences were consistent across the various stenosis locations and were insensitive to patient anatomy.
法洛四联症（ToF）的特征是右心室流出道部分狭窄，通常通过应用生物相容性材料制成的血管补片来缓解。在这项研究中，我们使用计算模拟来比较四种补片材料在不同狭窄位置的力学性能。通过对三位已修复 ToF 患者的肺动脉的三个解剖亚区中的每一个施加对称狭窄，创建了九个理想的术前 ToF 几何形状。实施了一种虚拟手术方法来复制血管减压、手术补片和再灌注后随后的血管扩张的步骤。在补片平均应力（p < 0.001）方面，补片材料之间存在显著差异。与合成补片材料（Dacron 和 PTFE）相比，生物补片材料（猪异种心包、人心包）表现出更高的补片应力。观察到的差异在各种狭窄位置都存在，并且不依赖于患者的解剖结构。
