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颈主动脉弓异常动脉瘤：手术修复可改善血流动力学。

Unusual Aneurysm of a Cervical Aortic Arch: Surgical Repair Improves Fluid Dynamics.

机构信息

3D and Computer Simulation Laboratory, IRCCS Policlinico San Donato, San Donato Milanese, Italy.

Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy.

出版信息

World J Pediatr Congenit Heart Surg. 2024 Mar;15(2):224-226. doi: 10.1177/21501351231196516. Epub 2023 Oct 18.

DOI:10.1177/21501351231196516
PMID:37853733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10949141/
Abstract

The cervical aortic arch is a rare congenital vascular abnormality related to the anomalous development of the aortic arch. We present the case of a 6-year-old patient with a large aneurysmal cervical aortic arch who underwent surgical correction and arch reconstruction. Surgical repair was indicated based on the risk of progressive dilation and rupture, aiming to restore correct geometry and hemodynamics. We evaluated preoperative and postoperative hemodynamics using computational fluid dynamics simulations, and we also identified, within the repaired region, an area that remains affected by greater turbulent flow, requiring follow-up surveillance.

摘要

颈总动脉弓是一种罕见的先天性血管异常，与主动脉弓的异常发育有关。我们报告了一例 6 岁大的颈总动脉弓巨大动脉瘤患者，该患者接受了手术矫正和弓重建。根据进行性扩张和破裂的风险，手术修复是必要的，目的是恢复正确的几何形状和血液动力学。我们使用计算流体动力学模拟评估了术前和术后的血液动力学，并且我们还在修复区域内发现了一个仍然受到更大湍流影响的区域，需要进行随访监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b3/10949141/eca0057cecdd/10.1177_21501351231196516-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b3/10949141/7c3f326842d4/10.1177_21501351231196516-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b3/10949141/eca0057cecdd/10.1177_21501351231196516-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b3/10949141/7c3f326842d4/10.1177_21501351231196516-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b3/10949141/eca0057cecdd/10.1177_21501351231196516-fig2.jpg

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本文引用的文献

1
Patient-Specific Bicuspid Aortic Valve Biomechanics: A Magnetic Resonance Imaging Integrated Fluid-Structure Interaction Approach.基于 MRI 的个体化二叶主动脉瓣生物力学：血流-结构相互作用分析方法
Ann Biomed Eng. 2021 Feb;49(2):627-641. doi: 10.1007/s10439-020-02571-4. Epub 2020 Aug 17.
2
Surgical repair of cervical aortic arch: An alternative classification scheme based on experience in 35 patients.颈主动脉弓手术修复：基于 35 例经验的另一种分类方案。
J Thorac Cardiovasc Surg. 2020 Jun;159(6):2202-2213.e4. doi: 10.1016/j.jtcvs.2019.03.143. Epub 2019 Jun 18.
3
Reversed Auxiliary Flow to Reduce Embolism Risk During TAVI: A Computational Simulation and Experimental Study.
反向辅助血流以降低经导管主动脉瓣植入术期间的栓塞风险：一项计算模拟与实验研究
Cardiovasc Eng Technol. 2019 Mar;10(1):124-135. doi: 10.1007/s13239-018-00386-y. Epub 2018 Oct 16.
4
Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease.冠状动脉壁切应力与冠状动脉疾病患者粥样斑块的进展和转化以及动脉重构有关。
Circulation. 2011 Aug 16;124(7):779-88. doi: 10.1161/CIRCULATIONAHA.111.021824. Epub 2011 Jul 25.
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Impact of aortic repair based on flow field computer simulation within the thoracic aorta.基于胸主动脉流场计算机模拟的主动脉修复效果。
Comput Methods Programs Biomed. 2011 Mar;101(3):243-52. doi: 10.1016/j.cmpb.2011.01.005. Epub 2011 Feb 12.
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Ann Biomed Eng. 2010 Feb;38(2):391-402. doi: 10.1007/s10439-009-9835-6. Epub 2009 Nov 5.
7
On coupling a lumped parameter heart model and a three-dimensional finite element aorta model.关于耦合一个集总参数心脏模型和一个三维有限元主动脉模型。
Ann Biomed Eng. 2009 Nov;37(11):2153-69. doi: 10.1007/s10439-009-9760-8. Epub 2009 Jul 17.
8
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Arteriosclerosis. 1985 May-Jun;5(3):293-302. doi: 10.1161/01.atv.5.3.293.