Author:
Sun Xiaoning,Li Siting,He Yuan,Liu Yuxi,Ma Tianxiang,Zeng Rong,Liu Zhili,Chen Yu,Zheng Yuehong,Liu Xiao
Abstract
AbstractChronic heart disease (CHD) is a common comorbidity of patients receiving endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA). The ventricular systolic function determines the hemodynamic environments in aorta, and thus regulating the formation of postoperative thrombus. However, the explicit relationship between ventricular systolic function and EVAR complication of thrombotic events is unknown. Here, we proposed a three-dimensional numerical model coupled with the lumped-elements heart model, which is capable of simulating thrombus formation in diverse systolic functions. The computational results demonstrate that thrombus tended to form on the interior side of the aorta arch and iliac branches, which is consistent with the four patients’ post-operative imaging follow-up. In addition, we found that the thrombus formation has negative correlations with the maximum ventricular contractile force (r=−0.2814±0.1012) and positive correlations with the minimum ventricular contractile force (r=0.238±0.074), whereas the effect of heart rate (r=−0.0148±0.1211) on thrombus formation is not significant. In conclusion, changes in ventricular systolic function may alter the risk of thrombotic events after EVAR repair, which could provide insight into the selection of adjuvant therapy strategies for AAA patients with CHD.
Publisher
Cold Spring Harbor Laboratory
Reference48 articles.
1. Outcomes of endovascular abdominal aortic aneurysm repair in high-risk patients
2. Isselbacher EM , Preventza O , Black JH, 3rd , Augoustides JG , Beck AW , Bolen MA , et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022.
3. Systematic Review and Meta-analysis of Factors Influencing Survival Following Abdominal Aortic Aneurysm Repair;European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery,2016
4. Mural thrombotic deposits in abdominal aortic endografts are common and do not require additional treatment at short-term and midterm follow-up;Journal of vascular and interventional radiology : JVIR,2008
5. Significance and Risk Factors for Intraprosthetic Mural Thrombus in Abdominal Aortic Endografts: A Systematic Review and Meta-analysis;Annals of vascular surgery,2018