导管泵辅助模式对心血管和冠状动脉血流动力学的影响

Effects of catheter pump auxiliary mode on cardiovascular and coronary hemodynamics

通过构建基于经皮导管泵辅助模式的心血管及冠状动脉系统的集中参数模型,采用数值仿真方法研究冠状动脉狭窄对患者血流动力学的影响,以及导管泵对冠状动脉系统的影响.研究结果表明:不同的导管泵辅助模式均可有效提高左主干狭窄合并心力衰竭患者心血管的心输出量,帮助左心室卸载;导管泵的变转速辅助模式和定转速辅助模式均可有效提高狭窄情况下冠状动脉的血液灌注量和冠脉血压,维持血流动力学的稳定;当左主干狭窄程度分别为60%和80%时,变转速辅助模式可分别辅助提高左主干血流量38.1%和47.4%,且均高于定转速辅助模式;相较于定转速辅助模式,变转速辅助模式在提高心输出量、狭窄冠脉的血流量以及提高血流的搏动性等方面,具有较明显的优势.

The Impella-like catheter pump assisted centralized parameter model of cardiovascular and coronary artery system was constructed to investigate the hemodynamics of patients with coronary stenosis and the influence of catheter pump on coronary artery system by numerical method.The results show that different auxiliary modes of catheter pump can effectively improve the cardiovascular cardiac output in patients with left main stenosis complicated with heart failure for helping the left ventricle unload.The variable speed model and constant speed model of the catheter pump can effectively improve the blood perfusion volume and coronary pressure of coronary artery in the case of stenosis to maintain the stability of hemodynamics.When the stenosis degrees of left main trunk are 60%and 80%,the flow rates of left main trunk can be respectively increased by 38.1%and 47.4%at variable speed,which are higher than those at constant speed mode.Compared with constant speed assisted mode,variable speed mode has obvious advantages for improving cardiac output,stenosis coronary artery flow and blood flow pulsatility.