心内Fontan搭桥手术中上下腔静脉的相对位置对血流动力学的影响

    Influence of Relative Positions of Superior and Inferior Vena Cava on Hemodynamics in Intraatrial Anastomosis of Fontan Surgical Planning

    • 摘要: 目的是研究手术规划过程中,在心内接管情况下,上下腔静脉的相对位置对修复部位相关区域血流动力学的影响.研究方法:第一,利用可视化人体数字切片图像三维重建肺动脉主干、左右肺动脉、上下腔静脉等心脏大血管;第二,在虚拟环境下,根据上下腔静脉的相对位置对模型进行计算机雕塑,建立3种手术规划模型;第三,对建立的模型进行数值模拟和分析.通过流动状态、总压、功率损失和分流率等因素比较各种手术方式,以期实现手术方案的优化.结果显示,下腔静脉右接的方式功率损失最小,分流率处于比较平衡的状态.

       

      Abstract: The influence of the relative intraatrial anastomoses positions of IVC to SVC on the hemodynamic performance is studied for surgical planning.First,to provide a theoretical basis for the clinical treatment,a 3D geometry model including pulmonary artery (PA),left (LPA) and right (RPA) pulmonary arteries,SVC,and IVC is reconstructed from medical images.Second,based on virtual environment,three surgical option models are sculptured according to the relative positions between the IVC and the SVC in a free form deformation.Finally,numerical simulations of hemodynamics are carried out.The flow structures,total pressures,power losses,and flow splits are analyzed to evaluate the optimal options.Results show that the right-IVC model performs a less power loss and relative balanced flow split,which may be the optimal option.

       

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