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 (c) 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.

Evaluation of different cannulation strategies for aortic arch surgery using a cardiovascular numerical simulator / De Lazzari, Beatrice; Capoccia, Massimo; Cheshire, Nicholas J; Rosendahl, Ulrich P; Badagliacca, Roberto; De Lazzari, Claudio. - In: BIOENGINEERING. - ISSN 2306-5354. - 10:1(2023). [10.3390/bioengineering10010060]

Evaluation of different cannulation strategies for aortic arch surgery using a cardiovascular numerical simulator

Badagliacca, Roberto;De Lazzari, Claudio
2023

Abstract

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 (c) 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.
2023
aortic arch; aortic surgery; cardiovascular modelling; carotid artery perfusion; lumped-parameter model; pressure–volume loop; software simulation; three-way cannulation approach
01 Pubblicazione su rivista::01a Articolo in rivista
Evaluation of different cannulation strategies for aortic arch surgery using a cardiovascular numerical simulator / De Lazzari, Beatrice; Capoccia, Massimo; Cheshire, Nicholas J; Rosendahl, Ulrich P; Badagliacca, Roberto; De Lazzari, Claudio. - In: BIOENGINEERING. - ISSN 2306-5354. - 10:1(2023). [10.3390/bioengineering10010060]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1670179
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