心室内隧道的补片形状设计及有限元分析  

Structure Design and Finite Element Analysis on Patch in Intraventricular Tunnel

作　　者：李晓[1,2] 王俊杰 柳思聪[1,2] 刘宁 杨印龙 杨尧[3] 范祥明 乔爱科 LI Xiao;WANG Junjie;LIU Sicong;LIU Ning;YANG Yinlong;YANG Yao;FAN Xiangming;QIAO Aike(Faculty of Environment and Life,Beijing University of Technology,Beijing 100124,China;Intelligent Physiological Measurement and Clinical Translation,Beijing International Base for Scientific and Technological Cooperation,Beijing 100024,China;Pediatric Heart Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]北京工业大学环境与生命学部,北京100124 [2]智能化生理测量与临床转化北京市国际科研合作基地,北京100124 [3]首都医科大学附属北京安贞医院小儿心脏中心外科,北京100029

出　　处：《医用生物力学》2022年第1期98-104,共7页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(11772015);北京市医院管理局临床技术创新项目2018年度“扬帆”计划(XMLX201845)。

摘　　要：目的探究心室内隧道(intraventricular tunnel,IVT)构建术的补片形状对右心室双出口矫治术力学性能的影响。方法基于理想化IVT模型,设计二维IVT补片。根据转弯部分菱形补片长短轴不同,建立长短轴比分别为1∶0.625、1∶0.3、1∶0.2、1∶0.15、1∶0.125、1∶0.1共计6组补片模型,利用有限元分析方法对补片缝合、保持、撑起为三维IVT模型的过程进行数值模拟。结果6组补片模型的缝合缘最大应力主要集中在转弯部分菱形锐角边缝合处;随着补片长短轴比增大,IVT缝合缘最大应力先减少后增大,体积呈现增大的趋势,隧道两端压差呈现先减小后增大的趋势。菱形长短轴比为1∶0.15补片的表面应力分布均匀,且缝合缘上最大应力最小,同时对右心室体积侵占较小,隧道两端的压差较小。结论IVT补片形状对IVT缝合缘应力、右心室体积及隧道压差有影响,而且不是单调变化。菱形长短轴比为1∶0.15的补片缝合效果在所建模型中相对较好。Objective To explore the influence of patch shape for intraventricular tunnel(IVT)construction on biomechanical performance of the double outlet right ventricle after correction.Methods Based on the idealized IVT model,a two-dimensional IVT patch was designed.Six groups of patch models with the rhombic long-to-short axis ratio of 1∶0.625,1∶0.3,1∶0.2,1∶0.15,1∶0.125,1∶0.1 were established according to the difference between the long and short axis of the rhombus patch in the turning part,and finite element analysis method was used to numerically simulate the process of stitching,holding and propping up the patch into a three-dimensional(3D)IVT model.Results The maximum stresses on suture line of 6 patch models were mainly concentrated at acute-angle corners of the rhombus.As rhombic long-to-short axis ratio of the patch increased,the maximum stress of the IVT suture line first decreased and then increased,and the volume showed an increasing trend.The pressure difference between two ends of the tunnel first decreased and then increased.The patch with the long-to-short axis ratio of 1∶0.15 had a uniform surface stress distribution,and the maximum stress on the suture line was the smallest.Meanwhile the right ventricular volume was less encroached on,and the pressure difference at both ends of the tunnel was small.Conclusions The IVT shape can influence stresses of suture line,the right ventricle volume and the pressure difference of IVT with non-monotonic variations.The suture effect of the patch with the long-to-short axis ratio of 1∶0.15 is relatively better among the constructed models.

关 键 词：右心室双出口 心室内隧道 补片 数值模拟 

分 类 号：R318.01[医药卫生—生物医学工程]