这项工作分析了两名老年患者主动脉内的血流动力学现象及其对血流行为的影响,特别受其中之一的血管内假体影响(患者II)。计算流体动力学(CFD)被用于这项研究,涉及速度的测量,压力,和在第三心动周期的各个时间点的壁剪切应力(WSS),在胸主动脉的两个横截面内的特定位置。第一个横截面(横截面1,CS1)位于初始流体分叉之前,就在右锁骨下动脉前.第二横截面(横截面2,CS2)位于紧接在左锁骨下动脉之后。结果表明,在常规主动脉几何结构下,速度和压力大小遵循流体动力学原理,显示变化。然而,在病人II,CS2附近的内置假体和内置假体的近端边界由于脉动流动而显着破坏了流体行为。患者I的横截面积小于患者II的横截面积,导致更高的流量大小。虽然在患者I的CS1中,速度大小有相当大的可变性,它们表现出更均匀和可预测的过渡。相比之下,病人II的CS2,幅度变化也很高的地方,由于内置假体的存在,显示不规则的流体行为。该横截面与流体分叉的边界重合。此外,血管内动脉瘤修复引起的不规则几何形状有助于血流中断,因为内置假体调整到内皮,重塑自身以符合血管壁。在这种情况下,速度值的显著变化,压差波动高达10%,和较低的壁剪切应力表明血管内假体对血流行为的显着影响。这些流动干扰,当心率加重时,可能会导致血管解剖结构和位移的变化,导致假体-内皮连续性的破坏,从而导致患者的临床并发症。
This work analyzes hemodynamic phenomena within the aorta of two elderly patients and their impact on blood flow behavior, particularly affected by an endovascular prosthesis in one of them (Patient II). Computational Fluid Dynamics (CFD) was utilized for this study, involving measurements of velocity, pressure, and wall shear stress (WSS) at various time points during the third cardiac cycle, at specific positions within two cross sections of the thoracic aorta. The first cross-section (Cross-Section 1, CS1) is located before the initial fluid bifurcation, just before the right subclavian artery. The second cross-section (Cross-Section 2, CS2) is situated immediately after the left subclavian artery. The results reveal that, under regular aortic geometries, velocity and pressure magnitudes follow the principles of fluid dynamics, displaying variations. However, in Patient II, an endoprosthesis near the CS2 and the proximal border of the endoprosthesis significantly disrupts fluid behavior owing to the pulsatile flow. The cross-sectional areas of Patient I are smaller than those of Patient II, leading to higher flow magnitudes. Although in CS1 of Patient I, there is considerable variability in velocity magnitudes, they exhibit a more uniform and predictable transition. In contrast, CS2 of Patient II, where magnitude variation is also high, displays irregular fluid behavior due to the endoprosthesis presence. This cross-section coincides with the border of the fluid bifurcation. Additionally, the irregular geometry caused by endovascular aneurysm repair contributes to flow disruption as the endoprosthesis adjusts to the endothelium, reshaping itself to conform with the vessel wall. In this context, significant alterations in velocity values, pressure differentials fluctuating by up to 10%, and low wall shear stress indicate the pronounced influence of the endovascular prosthesis on blood flow behavior. These flow disturbances, when compounded by the heart rate, can potentially lead to changes in vascular anatomy and displacement, resulting in a disruption of the prosthesis-endothelium continuity and thereby causing clinical complications in the patient.