主动脉破裂前远端支架移植物诱发新入口的敌对血流动力学:瞬态与稳态 CFD 模拟的比较。

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-03-01 Epub Date: 2023-07-28 DOI:10.1055/s-0043-1771357
Anja Osswald, Konstantinos Tsagakis, Ender Demircioglu, Alexander Weymann, Alina Zubarevich, Arjang Ruhparwar, Christof Karmonik
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引用次数: 0

摘要

背景:计算流体动力学(CFD)模拟对主动脉病变中的血流进行建模。我们的研究旨在了解冷冻象鼻后远端支架移植物诱发的新入口(dSINE)破裂部位的局部血流动力学环境,采用临床上时间有效的稳流模拟与瞬态模拟:方法:在 dSINE 发生前后和主动脉破裂前对其进行了稳态模拟。为了考虑 dSINE 位置的几何变化可能导致的湍流,采用了雷诺平均纳维-斯托克斯方程和可实现的 k-ε 湍流模型。为了进行比较,还进行了瞬态模拟。对主动脉不同位置的血液动力学参数进行了评估:结果:观察到dSINE后,由于管腔狭窄导致的喷射状血流在破裂前增加,并导致高低壁剪应力(WSS)的局灶邻近区域。破裂前,破裂部位的主动脉直径增大,降低了整个主动脉周缘的 WSS。与此同时,主动脉内弯处入口撕裂处上方的局部 WSS 和湍流增加。下游主动脉的湍流动能和 WSS 升高表明原生主动脉的应力增强。稳态模拟结果与瞬态模拟结果在质量上非常吻合:结论:在主动脉破裂前进行的临床时间尺度上可行的稳态流 CFD 模拟显示,dSINE 破裂部位的血流动力学环境恶劣,这与冗长的瞬态模拟结果一致。因此,我们开发的方法可能对治疗计划有价值,因为在治疗计划中快速评估局部血流动力学环境至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hostile Hemodynamics in Distal Stent Graft-Induced New Entry Prior to Aortic Rupture: A Comparison of Transient versus Steady-State CFD Simulations.

Background:  Computational fluid dynamics (CFD) simulations model blood flow in aortic pathologies. The aim of our study was to understand the local hemodynamic environment at the site of rupture in distal stent graft-induced new entry (dSINE) after frozen elephant trunk with a clinically time efficient steady-flow simulation versus transient simulations.

Methods:  Steady-state simulations were performed for dSINE, prior and after its development and prior to aortic rupture. To account for potential turbulences due geometric changes at the dSINE location, Reynolds-averaged Navier-Stokes equations with the realizable k-ε model for turbulences were applied. Transient simulations were performed for comparison. Hemodynamic parameters were assessed at various locations of the aorta.

Results:  Post-dSINE, jet-like flow due to luminal narrowing was observed which increased prior to rupture and resulted in focal neighbored regions of high and low wall shear stress (WSS). Prior to rupture, aortic diameter at the rupture site increased lowering WSS at the entire aortic circumference. Concurrently, WSS and turbulence increased locally above the entry tear at the inner aortic curvature. Turbulent kinetic energy and WSS elevation in the downstream aorta demonstrated enhanced stress on the native aorta. Results of steady-state simulations were in good qualitative agreement with transient simulations.

Conclusion:  Steady-flow CFD simulations feasible at clinical time scales prior to aortic rupture reveal a hostile hemodynamic environment at the dSINE rupture site in agreement with lengthy transient simulations. Consequently, our developed approach may be of value in treatment planning where a fast assessment of the local hemodynamic environment is essential.

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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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