计算流体力学在全腔-肺连接术血流模拟中的应用
首发时间:2014-03-06
摘要:【目的】 利用计算流体力学(Computational Fluid Dynamics,CFD)方法对不同全腔-肺连接术(Total Cavo-pulmonary Connection,TCPC)血管连接区域血流进行模拟,比较不同术式能量消耗的大小。 【方法】 对心内隧道TCPC、心外管道TCPC和主肺动脉下拉与下腔静脉直接吻合式TCPC三种术式的血管连接结构内血流进行CFD模拟,并通过增加下腔静脉流量模拟不同程度的运动状态对于血流动力学特征的影响。【结果】在3个TCPC结构中,随着下腔静脉血流的增大,能量消耗均有明显增加。当左、右肺流量相等时,在心内隧道TCPC结构中,3倍下腔静脉流量时的能量消耗是静息状态下的7.88倍。相反,在主肺动脉下拉与下腔静脉直接吻合的TCPC结构中,3倍下腔静脉流量时的能量消耗仅为静息状态下的2.86倍。在心外管道TCPC中,3倍下腔静脉流量时的能量消耗为静息状态下的3.34倍。【结论】在心内隧道TCPC结构中,当下腔静脉血流量增加时,对于连接结构能量消耗的影响最大。相反,在主肺动脉下拉与下腔静脉直接吻合的TCPC结构中,能量消耗随下腔静脉血流的增加最不明显。下腔静脉血流量增大对于心外管道TCPC结构能量消耗的影响介于心内隧道TCPC结构和主肺动脉下拉与下腔静脉直接吻合的TCPC结构之间。
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Using of Computational Fluid Dynamics in The Numerical Simulation of Blood Flow of Total Cavo-pulmonary Connections
Abstract:Low energy efficiency of the total cavo-pulmonary connection(TCPC) in exercise conditions may lead to limited post-operative exercise capacity of the patients. The objective of this study is to compare the power loss of different types of TCPC operations in exercise conditions. In this study, the flow rate of inferior vena cava (IVC) was increased artificially to simulate exercise conditions. The control volume power loss were investigated in three types of TCPC modifications using the method of computational fluid dynamics (CFD). In the intracardiac tunnel TCPC, the power loss was 7.88 times of that calculated in resting state when the flow rate of IVC increased to 3 times of that measured at the right pulmonary artery flow ratio of 50%.On the contrary, in the extracardiac Fontan with direct cavopulmonary anastomosis (direct TCPC), the magnitude of power loss was only 2.86 times of that in resting state. The results of extracardiac conduit TCPC fell in between. It showed that direct TCPC had higher energy efficiency than intracardiac tunnel or extracardiac conduit TCPC in exercise conditions.
Keywords: total cavo-pulmonary connection computational fluid dynamics power loss
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