Hemodynamic analysis of postoperative reintervention for Stanford type A aortic dissection / 中华胸心血管外科杂志

ABSTRACT

Objective:A residual false lumen progress risk prediction model was constructed based on computational fluid dynamics and biomechanical parameters were calculated to assess the factors affecting the long-term reintervention after the first operation.Methods:Patients with Stanford type A aortic dissection admitted to Fuwai hospital were retrospectively collected and divided into control group and thoracoabdominal aortic replacement group according to long-term prognosis or history of reintervention. The fluid parameters of the descending aorta were calculated based on the early CTA imaging data after first operation. The differences of parameters between the two groups were compared to explore the risk factors.Results:A total of 24 patients were included from January 2015 to May 2021. The average age was(47.88±9.84) years old, 21(87.5%) male, and 3 female. The balance position of luminal pressure difference in the descending aorta was closer to the opening of the left subclavicular artery[(22.00±3.91)cm vs.(36.00±1.77)cm, P<0.001], and the false lumen pressure was greater than the true lumen pressure in the thoracoabdominal aortic replacement group. Conclusion:The computational fluid dynamics method can simplify and visualize the complex human blood flow and postoperative structure based on the mathematical model. The lumen pressure balance point moving to the proximal are the risk factors for poor remodeling of the descending aorta and reintervention.