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单心室循环新型混合综合二期手术的计算机模拟与体外分析

In-Silico and In-Vitro Analysis of the Novel Hybrid Comprehensive Stage II Operation for Single Ventricle Circulation.

作者信息

Das Arka, Hameed Marwan, Prather Ray, Farias Michael, Divo Eduardo, Kassab Alain, Nykanen David, DeCampli William

机构信息

Department of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA.

Department of Mechanical Engineering, American University of Bahrain, Riffa 942, Bahrain.

出版信息

Bioengineering (Basel). 2023 Jan 19;10(2):135. doi: 10.3390/bioengineering10020135.

Abstract

Single ventricle (SV) anomalies account for one-fourth of all congenital heart disease cases. The existing palliative treatment for this anomaly achieves a survival rate of only 50%. To reduce the trauma associated with surgical management, the hybrid comprehensive stage II (HCSII) operation was designed as an alternative for a select subset of SV patients with the adequate antegrade aortic flow. This study aims to provide better insight into the hemodynamics of HCSII patients utilizing a multiscale Computational Fluid Dynamics (CFD) model and a mock flow loop (MFL). Both 3D-0D loosely coupled CFD and MFL models have been tuned to match baseline hemodynamic parameters obtained from patient-specific catheterization data. The hemodynamic findings from clinical data closely match the in-vitro and in-silico measurements and show a strong correlation (r = 0.9). The geometrical modification applied to the models had little effect on the oxygen delivery. Similarly, the particle residence time study reveals that particles injected in the main pulmonary artery (MPA) have successfully ejected within one cardiac cycle, and no pathological flows were observed.

摘要

单心室(SV)异常占所有先天性心脏病病例的四分之一。针对这种异常的现有姑息治疗的生存率仅为50%。为了减少与手术管理相关的创伤,混合综合二期(HCSII)手术被设计为一种替代方案,用于一部分具有足够主动脉顺行血流的SV患者。本研究旨在利用多尺度计算流体动力学(CFD)模型和模拟血流回路(MFL),更好地了解HCSII患者的血流动力学。3D-0D松耦合CFD模型和MFL模型均已进行调整,以匹配从患者特异性导管插入术数据获得的基线血流动力学参数。临床数据的血流动力学结果与体外和计算机模拟测量结果密切匹配,并显示出很强的相关性(r = 0.9)。应用于模型的几何形状修改对氧输送影响很小。同样,颗粒停留时间研究表明,注入主肺动脉(MPA)的颗粒在一个心动周期内成功排出,未观察到病理性血流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/907b/9952694/222d1cda7423/bioengineering-10-00135-g0A1.jpg

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