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首页> 外文期刊>Artificial Organs >Computational Modeling of Neonatal Cardiopulmonary Bypass Hemodynamics With Full Circle of Willis Anatomy
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Computational Modeling of Neonatal Cardiopulmonary Bypass Hemodynamics With Full Circle of Willis Anatomy

机译：完整的Willis解剖学圈新生儿心肺旁路血流动力学的计算模型

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Cardiopulmonary bypass (CPB) procedure is employed to repair most congenital heart defects (CHD). Cannulation is a critical component of this procedure where the location and diameter of cannula controls the hemodynamic performance. State-of-the-art computational studies of neonatal CPB employed an isolated aortic arch region by truncating the three-dimensional (3D) patient-specific cerebral system. The present work expanded these studies where the 3D patient-specific MRI reconstruction of the cerebral system, including the Circle of Willis (CoW), is integrated with a hypoplastic neonatal aortic arch. The inlet of the arterial cannula is assigned a steady velocity boundary condition of the CPB pump, while all outlets are modeled as resistance boundary conditions, thus allowing acute comparisons between different cannula configurations. Three-dimensional (3D) flow simulations in the aortic arch model are performed at a Reynolds number of 2150 using an experimentally validated commercial solver. Results demonstrate that the inclusion of 3D CoW is essential to predict the accurate head-neck blood perfusion and therefore critical in deciding the neonatal aortic cannulation strategy preoperatively. Using this integrated model two CPB configurations are studied, where the cannulas were placed at innominate artery (IA) (IA-cannula configuration) and ductus arteriosus (DA) (DA-cannula configuration). Configuration change produced significant differences in flow splits and local hemodynamics of blood flow throughout the whole aortic arch, neck and cerebral arteries. Percent flow rate differences between the IA- and DA-cannula configurations are computed to be: 19%, for descending aorta, 198% for ascending aorta (perfusing coronary arteries), 91% for right anterior cerebral artery, and 68% for left anterior cerebral artery. Another important finding is the retrograde flow at vertebral arteries for IA-cannula configuration, but not for DA-cannula. These results may help to translate better neonatal arterial cannulae design for minimizing cerebral complications during CPB procedures.
机译：体外循环（CPB）程序用于修复大多数先天性心脏缺陷（CHD）。插管是该过程的关键组成部分，其中插管的位置和直径可控制血液动力学性能。新生儿CPB的最新计算研究通过截断患者特定的三维（3D）脑系统采用了孤立的主动脉弓区。目前的工作扩展了这些研究，其中将包括威利斯环（CoW）在内的大脑系统的3D特定于患者的MRI重建与增生的新生儿主动脉弓结合在一起。动脉插管的入口分配有CPB泵的稳定速度边界条件，而所有出口均建模为阻力边界条件，因此可以对不同插管配置进行严格比较。使用经过实验验证的商用求解器，以2150的雷诺数执行主动脉弓模型中的三维（3D）流动模拟。结果表明，包含3D CoW对预测准确的头颈部血液灌注至关重要，因此对于术前确定新生儿主动脉插管策略至关重要。使用此集成模型，研究了两种CPB配置，其中将插管放置在无名动脉（IA）（IA-插管配置）和动脉导管（DA）（DA-插管配置）处。形态变化在整个主动脉弓，颈和脑动脉的血流分裂和局部血流动力学方面产生了显着差异。 IA和DA插管配置之间的流速差异百分比计算为：降主动脉为19％，升主动脉（灌注冠状动脉）为198％，右前脑动脉为91％，左前动脉为68％脑动脉。另一个重要发现是IA插管配置在椎动脉的逆行血流，而DA插管则不在。这些结果可能有助于翻译更好的新生儿动脉套管设计，以最大程度地减少CPB手术期间的脑部并发症。

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