双叶机械瓣膜不同植入角度对主动脉血流动力学的影响
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国家自然科学基金项目(32071311)


Effects of Different Implantation Angles of Bi-Leaflet Mechanical Heart Valve on Hemodynamics in the Aorta
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    摘要:

    目的 研究双叶机械瓣膜(bileaflet mechanical heart valve,BMHV)不同植入角度对升主动脉旋动流的影响。方法 基于1位健康自愿者主动脉CT图像,采用计算机数值模拟方法,在定常流条件下,比较研究4种不同瓣膜植入角度(0°、45°、90°和135°)对主动脉旋动流的影响。结果 BMHV植入会严重干扰主动脉内的旋动流,影响升主动脉处的旋动流结构和旋动流强度分布,在瓣膜下游出现扰流区。135°植入角度对旋动流的破坏最大,产生逆向旋动区域最多;0°和45°角植入对旋动流破坏相对较小。植入角为0°时主动脉低壁面剪切应力(<0.5 Pa)所覆盖面积最小。结论 植入角度为0°~45°时,BMHV对升主动脉内旋动流破坏相对较小。因此,对不同患者而言,应根据其主动脉(包括主动脉窦)的空间几何构型进行个性化选择,植入角度可在0°~45°之间确定。

    Abstract:

    Objective To study the effects of different implantation angles of bi-leaflet mechanical heart valve (BMHV) on swirling flow in the aorta. Methods Based on the aortic CT images of a healthy volunteer, the effects of 4 different valve implantation angles (0° , 45° , 90° and 135°) on the aortic rotational flow under constant flow conditions were studied by computational simulation. Results The implantation of BMHV could seriously interfere with the aortic rotational flow, affecting the structure and helicity distributions of the rotational flow in ascending aorta, thus resulting in disturbed blood flows distal to the valve. The 135° implantation angle caused the most disruption to the swirling flow, leading to the largest areas of reversed rotational flows, while the 0° and 45° implantation angles caused relatively smaller damage to the swirling flow. The areas with low wall shear stress (<0.5 Pa) were the smallest when the implantation angle of BMHV was 0°. Conclusions At the implantation angle of 0°–45°, the disruption of BMHV to the swirling flow in ascending aorta was relatively small. Therefore, for different patients, the selection of implantation angle should be individualized according to the spatial geometry of their aorta (including the aortic sinuses), and the implantation angle can be determined between 0°–45°.

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刘晶鑫,邓小燕,敖海勇,张全超.双叶机械瓣膜不同植入角度对主动脉血流动力学的影响[J].医用生物力学,2024,39(4):685-690

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  • 收稿日期:2024-03-26
  • 最后修改日期:2024-04-02
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  • 在线发布日期: 2024-08-26
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