双侧双向Glenn手术的全三维血液动力学数值分析

Three-Dimensional Numerical Simulation of Hemodynamics for Bilateral Bidirectional Glenn

采用计算流体动力学方法,探讨双侧、双向Glenn术后腔-肺连接区域的能量损失情况。通过对患者核磁共振成像处理,完成了左、右肺动脉和左、右上腔静脉连接段的全三维数字化重构,结合相关血液流量等MRI测量结果,模拟了左、右肺动脉不同流量条件下连接段内的血液流动细节。结果表明:在肺动脉不同流量的情况下,腔-肺连接段内的能量损失相差2倍左右,血液流场形态对其有重要影响。由此得出结论:患者术后腔-肺连接段内的血流能量损失较小,人体肺动脉阻力大小决定左右肺的血流分配。在Fontan手术之前对Glenn连接结构进行血液流场的数值分析具有临床意义。

To simulate the blood flow in cavopulmonary anastomosis with bilateral superior vena cavae, we reconstructed threedimensional geometry of the connection based on the Magnetic Resonance Images （MRIs）, Clinical data of mean flow rates in left and right superior vena cava were imposed on the computational fluid dynamics （CFD） model as inflow boundary conditions, The blood flow at different ratios of left pulmonary artery/right pulmonary artery was numerically modeled, Results showed that the energy losses at different levels of predetermined pulmonary flow ratios were different, which was mainly affected by flow structures within the connection and pulmonary arteries. It is necessary to simulate blood flow in different cavopulmonary anastomosis. This may provide essential information for surgical design and eventually lead to the improvement in the diagnosis and treatment of functional single ventrile.