Haemodynamic simulations using one-dimensional (1-D) computational models exhibit many of the features of the systemic circulation under normal and diseased conditions. We propose a novel linear 1-D dynamical theory of blood flow in networks of flexible vessels that is based on a generalized Darcy's model and for which a full analytical solution exists in frequency domain. We assess the accuracy of this formulation in a series of benchmark test cases for which computational 1-D and 3-D solutions are available. Accordingly, we calculate blood flow and pressure waves, and velocity profiles in the human common carotid artery, upper thoracic aorta, aortic bifurcation, and a 20-artery model of the aorta and its larger branches. Our analytical solution is in good agreement with the available solutions and reproduces the main features of pulse waveforms in networks of large arteries under normal physiological conditions. Our model reduces computational time and provides a new approach for studying arterial pulse wave mechanics; e.g., the analyticity of our model allows for a direct identification of the role played by physical properties of the cardiovascular system on the pressure waves.
Several studies suggest that central (aortic) blood pressure (cBP) is a better marker of cardiovascular disease risk than peripheral blood pressure (pBP). The morphology of the pBP wave, usually assessed non-invasively in the arm, differs significantly from the cBP wave, whose direct measurement is highly invasive. In particular, pulse pressure, PP (the amplitude of the pressure wave), increases from central to peripheral arteries, leading to the so-called pulse pressure amplification (ΔPP). The main purpose of this study was to develop a methodology for estimating central PP (cPP) from non-invasive measurements of aortic flow and peripheral PP. Our novel approach is based on a comprehensive understanding of the main cardiovascular properties that determine ΔPP along the aortic-brachial arterial path, namely brachial flow wave morphology in late systole, and vessel radius and distance along this arterial path. This understanding was achieved by using a blood flow model which allows for workable analytical solutions in the frequency domain that can be decoupled and simplified for each arterial segment. Results show the ability of our methodology to (i) capture changes in cPP and ΔPP produced by variations in cardiovascular properties and (ii) estimate cPP with mean differences smaller than 3.3 ± 2.8 mmHg on in silico data for different age groups (25–75 years old) and 5.1 ± 6.9 mmHg on in vivo data for normotensive and hypertensive subjects. Our approach could improve cardiovascular function assessment in clinical cohorts for which aortic flow wave data is available.
We study the dynamics of microfluidic interfaces driven by pulsatile pressures in the presence of neutral and hydrophilic walls. For this, we propose a new phase field model that takes inertia into account. For neutral wetting, the interface dynamics is characterized by a response function that depends on a non-dimensional frequency, which involves the time scale associated with inertia. We have found a regime, for large values of this non-dimensional frequency, in which inertia is relevant, and our model is necessary for a correct description of the dynamics. For hydrophilic walls, the dynamics of the contact line with pulsatile forcing is basically undistinguishable to the dynamics of imbibition solely due to wetting. However, we observe that the presence of inertia causes the interface to advance faster than in the absence of pulsatile forcing. This is because pulsatile forcing induces inertia at the bulk to cooperate with wetting creating an enhancement of the imbibition process. We characterize this complex dynamics with transitory exponents that, at early times, are larger than the Washburn ones, and tend to the Washburn exponent at long times, when the interface feels less and less the driving force applied at the entrance of the microchannel, and the dynamics is dominated solely by wetting.
Since 2007, various urological procedures have been performed with laparoendoscopic single-site surgery (LESS surgery), including nephrectomy, pyeloplasty, simple prostatectomy and, with the refinement of laparoscopic instrumentation, radical prostatectomy. This paper reports our initial experience in radical prostatectomy using the SILS Port from Covidiem and two lateral 5-mm trocars for triangulation. The SILS Port allows for accurate, simple insertion through a Hadson incision. The flexible port accommodates three 5-mm cannulas or two 5-mm cannulas and a 12-mm port for easier instrument exchange through a single incision. This approach decreases morbidity from bleeding, hernia and/or internal organ damage and improves cosmetic. One-port single-incision laparoscopy is part of the natural development of minimally invasive surgery. Future research is required to assess the intraoperative and postoperative benefits of LESS surgery as compared to standard laparoscopy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.