目的:本研究旨在评估增大的左心房(LA)中的血流停滞,并证明左心房折叠(LAP)可以减轻停滞。
方法:纳入了5例慢性房颤患者,这些患者接受了二尖瓣手术,随后接受了直径≥60mm的扩大LA的LAP。我们使用术前和术后计算机断层扫描和四维流磁共振成像进行了计算流体动力学(CFD)分析。此外,计算机图形学用于创建虚拟左心耳切除术(LAAR)图像.我们进行了CFD分析,以评估三组在LA中的血流停滞:术前,LAAR,和LAP。
结果:当术前平均和恒定停滞体积均设定为100时,LAAR和LAP组的平均停滞体积分别为67.42±18.64和35.88±8.20。这些组的恒定停滞体积分别减少到45.01±7.43和21.14±7.70。与LAAR组相比,LAP组的平均停滞量和恒定停滞量也显着降低(分别为p=0.006和p=0.033)。
结论:在左心耳和扩大的LA中发现血流停滞。CFD分析显示,扩大LA的LAP比单独的虚拟LAAR更能改善血流停滞。
背景:UMIN000049923.
OBJECTIVE: This
study aimed to evaluate blood flow
stagnation in an enlarged left atrium (LA) and prove that left atrial plication (LAP) could alleviate the
stagnation.
METHODS: Five patients with chronic atrial fibrillation who underwent mitral valve surgery followed by LAP for an enlarged LA with a ≥ 60-mm diameter were included. We performed computational fluid dynamics (CFD) analysis using preoperative and postoperative computed tomography and four-dimensional flow magnetic resonance imaging. Additionally, computer graphics were used to create virtual left atrial appendage resection (LAAR) images. We performed CFD analysis to assess blood flow stagnation in the LA for three groups: preoperative, LAAR, and LAP.
RESULTS: When the average and constant stagnation volumes were both set to 100 preoperatively, the average stagnation volumes of the LAAR and LAP groups were 67.42 ± 18.64 and 35.88 ± 8.20, respectively. The constant
stagnation volumes of these groups reduced to 45.01 ± 7.43 and 21.14 ± 7.70, respectively. The LAP group also had significantly lower average and constant
stagnation volumes than those in the LAAR group (p = 0.006 and p = 0.033, respectively).
CONCLUSIONS: Blood flow
stagnation was noted in the LAA and enlarged LA. CFD analysis revealed that LAP for the enlarged LA improved blood flow stagnation more than the virtual LAAR alone.
BACKGROUND: UMIN000049923.