使用粒子图像测速仪 (PIV) 分析通过主动脉上分支之间解剖外旁路的流量。

IF 2.3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Clinical Medicine Insights. Cardiology Pub Date : 2024-03-04 eCollection Date: 2024-01-01 DOI:10.1177/11795468231221413
Petra N Williamson, Paul D Docherty, Adib Khanafer, Briana M Steven
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引用次数: 0

摘要

主动脉上动脉解剖外去瓣术(SAD)是一种人工外科移植物,用于对治疗主动脉升部和弓部病变的外科手术或混合手术中阻塞的头颈部动脉进行血管再通。然而,绕过主动脉上动脉但不堵塞其开口可能会引入竞争性血流,从而降低旁路的通畅性。此前尚未发现主动脉上动脉旁路内的竞争性血流。这项研究确定了预防性加入从肱脑动脉(BCA)到左颈总动脉(LCCA)以及从左颈总动脉到左锁骨下动脉(LSA)的旁路所引起的血液动力学。四种模型配置调查了竞争性血流的风险以及有意阻断近端 LSA 和/或 LCCA 的必要性。粒子图像测速仪(PIV)用于评估每种模型配置的血流动力学。我们发现,当 LSA 受阻时,BCA-LCCA 旁路中可能存在竞争性血流;当 LSA-LCCA 旁路中仅 LCCA 受阻或 LCCA 和 LSA 受阻时,LSA-LCCA 旁路中也可能存在竞争性血流。在 RCCA-LCCA 旁路中,血流在收缩期开始时停滞,整个收缩期血流中出现明显的再循环区和往复流动。当 LCCA 受阻时,LCCA-LSA 旁路内的血流也会停滞。当 LCCA 和 LSA 均堵塞时,LCCA-LSA 旁路出现大量再循环。所有其他配置中都存在竞争性血流,这表明一旦完成去瓣膜手术和胸腔内血管主动脉修复术(TEVAR),就有必要阻断或结扎原生 LCCA 和 LSA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Flow Through Extra-Anatomic Bypasses Between Supra-Aortic Branches Using Particle Image Velocimetry (PIV).

Supra-aortic extra-anatomic debranch (SAD) are prosthetic surgical grafts used to revascularize head and neck arteries that would be blocked during a surgical or hybrid procedure used in treating ascending and arch of the aorta pathologies. However, bypassing the supra-aortic arteries but not occluding their orifice might introduce potential for competitive flow that reduces bypass patency. Competitive flow within the bypasses across the supra-aortic arteries has not previously been identified. This research identified haemodynamics due to prophylactic inclusion of bypasses from the brachiocephalic artery (BCA) to the left common carotid artery (LCCA), and from the LCCA to left subclavian artery (LSA). Four model configurations investigated the risk of competitive flow and the necessity of intentionally blocking the proximal LSA and/or LCCA. Particle image velocimetry (PIV) was used to assess haemodynamics in each model configuration. We found potential for competitive flow in the BCA-LCCA bypass when the LSA was blocked, in the LSA-LCCA bypass, when the LCCA alone or LCCA and LSA were blocked. Flow stagnated at the start of systole within the RCCA-LCCA bypass, along with notable recirculation zones and reciprocating flow occurring throughout systolic flow. Flow also stagnated in the LCCA-LSA bypass when the LCCA was blocked. There was a large recirculation in the LCCA-LSA bypass when both the LCCA and LSA were blocked. The presence of competitive flow in all other configurations indicated that it is necessary to block or ligate the native LCCA and LSA once the debranch is made and the thoracic endovascular aortic repair (TEVAR) completed.

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来源期刊
Clinical Medicine Insights. Cardiology
Clinical Medicine Insights. Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.20
自引率
3.30%
发文量
16
审稿时长
8 weeks
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