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首页> 外文期刊>Artificial Organs >The impact of aortic/subclavian outflow cannulation for cardiopulmonary bypass and cardiac support: a computational fluid dynamics study.
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The impact of aortic/subclavian outflow cannulation for cardiopulmonary bypass and cardiac support: a computational fluid dynamics study.

机译：主动脉/锁骨下流出插管对体外循环和心脏支持的影响：计算流体动力学研究。

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摘要

Approximately 100 000 cases of oxygen deficiency in the brain occur during cardiopulmonary bypass (CPB) procedures each year. In particular, perfusion of the carotid and vertebral arteries is affected. The position of the outflow cannula influences the blood flow to the cardiovascular system and thus end organ perfusion. Traditionally, the cannula returns blood into the ascending aorta. But some surgeons prefer cannulation to the right subclavian artery. A computational fluid dynamics study was initially undertaken for both approaches. The vessel model was created from real computed tomography/magnetic resonance imaging data of young healthy patients. The simulations were run with usual CPB conditions. The flow distribution for different cannula positions in the aorta was studied, as well as the impact of the cannula tip distance to vertebral artery for the subclavian position. The study presents a fast method of analyzing the flow distribution in the cardiovascular system, and can be adapted for other applications such as ventricular assist device support. It revealed that two effects cause the loss of perfusion seen clinically: a vortex under the brachiocephalic trunk and low pressure regions near the cannula jet. The results suggest that cannulation to the subclavian artery is preferred if the cannula tip is sufficiently far away from the branch of the vertebral artery. For the aortic positions, however, the cannula should be injected from the left body side.
机译：每年在体外循环（CPB）程序中发生约10万例大脑缺氧。特别地，颈动脉和椎动脉的灌注受到影响。流出套管的位置会影响流向心血管系统的血液，从而影响器官的灌注。传统上，插管将血液返回到升主动脉。但是一些外科医生比右锁骨下动脉更喜欢插管。最初针对这两种方法进行了计算流体动力学研究。血管模型是根据年轻健康患者的真实计算机断层扫描/磁共振成像数据创建的。仿真是在常规CPB条件下进行的。研究了在主动脉中不同插管位置的流量分布，以及锁骨下位置插管尖端距离对椎动脉的影响。这项研究提出了一种分析心血管系统中流量分布的快速方法，并且可以适用于其他应用，例如心室辅助设备支撑。它揭示了两种作用导致临床上无法看到的灌注损失：头臂干下的涡流和套管射流附近的低压区。结果表明，如果套管尖端距离椎动脉的分支足够远，则优选锁骨下动脉插管。但是，对于主动脉位置，应从左侧身体一侧插入套管。

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