Computerized virtual surgery based on computational fluid dynamics simulation for planning coronary revascularization with aortic root replacement in adult congenital heart disease: a case report.

• 影响指数: 1.227
• 发表时间: Apr 2021
• 来源期刊: Gen Thorac Cardiovasc Surg
• DOI: 10.1007/s11748-020-01517-w
• PMID: 33130943
• 文章类型: Case Reports
• 作者列表: Hohri Y,Itatani K,Yamazaki S,Yaku H

关键词: Adult congenital heart disease; Blood flow imaging; CFD simulation; Computerized virtual surgery; Supravalvular aortic stenosis

Mesh: Adult; Aorta; Aortic Stenosis, Supravalvular; Aortic Valve / diagnostic imaging surgery; Female; Heart Defects, Congenital / diagnostic imaging surgery; Humans; Hydrodynamics

Abstract

A 38-year-old woman presented with exertional dyspnea and chest compression. She had undergone repair of congenital supravalvular aortic stenosis at 8 years of age. Contrast-enhanced computed tomography showed re-stenosis in the ascending aorta, bilateral coronary arterial aneurysm, and a highly thickened left ventricular wall. Release of stenosis was necessary to avoid left ventricular functional deterioration; however, it could cause demand-supply mismatch in coronary flow due to substantial left ventricular hypertrophy. Sufficient statistical evidence was not available in this situation; therefore, computerized virtual surgery based on computational fluid dynamics (CFD) was performed to predict the postoperative hemodynamics. Consequently, root replacement with in situ Carrel patch coronary reconstruction was considered a better option than coronary artery graft bypass in the left-side coronary flow supply. The patient underwent root replacement with in situ Carrel patch coronary reconstruction as planned based on CFD without any complication and was discharged 15 days postoperatively.