冠状动脉搭桥术中移植管-宿主动脉直径比和缝合角的优化与分析

Optimization and analysis of graft-host diameter ratio and junction angle in coronary artery bypass graft

目的探索怎样的移植管-宿主动脉直径比和缝合角可以最大限度地提高冠状动脉搭桥术的成功率。方法借助ANSYS9.0对冠状动脉搭桥术进行模拟仿真,用响应面方法建立数学模型,利用优化理论寻找最优的移植管-宿主动脉直径比和缝合角,使影响手术成功率的主要因素-壁面切应力梯度最小。结果结果表明冠状动脉搭桥术中,大移植管-宿主动脉直径比和小缝合角的模型具有更好的血流动力特性。结论影响冠状动脉搭桥术成功率的因素很多,在现有条件下借助临床经验指导,选择尽可能大的移植管-宿主动脉直径比和尽可能小的缝合角的做法是可取的。

Objective Try to find out the best graft-host diameter ratio and junction angle that can furthest improve success rate in coronary artery bypass graft （CABG）. Method ANSYS9.0 was used to simulate CABG, and response surface methodology （RSM） was applied to construct the mathematical model, last theory of optimization was performed to search the optimum graft-host diameter ratio and junction angle which can make the primary factor influencing success rate-wall shear stress gradient （WSSG） to be the smallest. Result The model with large graft-host diameter ratio and small junction angle has better hemodynamics feature in CABG. Conclusion There are many factors influencing success rate in CABG, at present, it is advisable to adopt graft-host diameter ratio as large as possible and junction angle as small as possible with help of clinic experience.