锁-腹搭桥治疗主动脉夹层的数值模拟实验

Numerical simulation of treating aortic dissection using artery-abdominal aorta bypass graft

主动脉夹层是一种较常见又很凶险的疾病,具有较高的死亡率。旁路搭桥转流术治疗DeBakey Ⅲ型主动脉夹层较一般的胸主动脉置换具有突出的优势,而且对于某些患者而言也是不可避免需要采用的手段。为了探讨锁-腹搭桥对主动脉夹层假腔内血流动力学参数的影响及该术式的有效性,分别构建了DeBakey Ⅲ型主动脉夹层及其锁-腹搭桥的理想化三维几何模型,然后将模型导入ANSYS 11.0中进行有限元分析。数值模拟结果显示,在实施搭桥后假腔入口处和假腔内的血流速度与压力均小于搭桥前。这对于减轻血流对夹层病变的冲击、减缓破裂口的进一步扩大、防止夹层破裂、促进夹层局部病变愈合是非常有利的。所以,锁-腹搭桥是一种在特定情况下治疗DeBakeyⅢ型主动脉夹层的有效方式,具有一定的临床应用前景。

Aortic dissection is a common disease which is very dangerous, with high mortality rate. Bypass graft for the treatment of DeBakey Ⅲ dissection has outstanding advantages than the ordinary replacement of thoracic aorta, and some patients will inevitably require the use of the procedure. The purpose of this study was to explore the impact of the subclavian artery-abdominal aorta bypass graft on hemodynamic parameters in the false lumen and the effectiveness of surgical treatment. First of all, the idealized three-dimensional geometric models of DeBakey Ⅲ aortic dissection and its subclavian artery-abdominal aorta bypass graft operation were constructed, respectively. Then the models were imported into ANSYS 11.0 for finite element analysis. Results of numerical simulation showed that both velocity and pressure of the blood flow were reduced after bypass graft at the entrance and in the internal sac of false lumen, which is very favorable for reducing the impact of blood flow on false lumen, slowing down the further expansion of entrance, preventing the breakdown of false lumen, and promoting the healing of dissection. Therefore, the subclavian artery-abdominal aorta bypass graft operation is an effective surgical method for the treatment of DeBakey Ⅲ aortic dissection in some particular cases. This operation is with great prospects for clinical application.