| Autor: |
De Lazzari B; Human Movement and Sport Sciences, 'Foro Italico' University of Rome, 00147 Rome, Italy., Capoccia M; Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK.; Department of Biomedical Engineering, University of Strathclyde, Glasgow G4 0NW, UK., Cheshire NJ; Aortic Centre, Royal Brompton Hospital, London SW3 6NP, UK., Rosendahl UP; Aortic Centre, Royal Brompton Hospital, London SW3 6NP, UK., Badagliacca R; Department of Clinical, Internal Anesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, 00147 Rome, Italy., De Lazzari C; National Research Council, Institute of Clinical Physiology (IFC-CNR), 00185 Rome, Italy.; Faculty of Medicine, Teaching University Geomedi, 0114 Tbilisi, Georgia. |
| Abstrakt: |
Aortic disease has a significant impact on quality of life. The involvement of the aortic arch requires the preservation of blood supply to the brain during surgery. Deep hypothermic circulatory arrest is an established technique for this purpose, although neurological injury remains high. Additional techniques have been used to reduce risk, although controversy still remains. A three-way cannulation approach, including both carotid arteries and the femoral artery or the ascending aorta, has been used successfully for aortic arch replacement and redo procedures. We developed circuits of the circulation to simulate blood flow during this type of cannulation set up. The CARDIOSIM© cardiovascular simulation platform was used to analyse the effect on haemodynamic and energetic parameters and the benefit derived in terms of organ perfusion pressure and flow. Our simulation approach based on lumped-parameter modelling, pressure-volume analysis and modified time-varying elastance provides a theoretical background to a three-way cannulation strategy for aortic arch surgery with correlation to the observed clinical practice. |
