Effect of arteriovenous graft flow rate on vascular access hemodynamics in a novel modular anastomotic valve device

McNally, Andrew; Akingba, A. George; Sucosky, Philippe

doi:10.1177/1129729818758229

Cited by 6 publications

(12 citation statements)

References 35 publications

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“…We point out that many of these assumptions have already been used in literature. For example, [27,33,47,48] treated blood flow as laminar flow of viscous Newtonian fluid; [34,37] assumed that the graft and vein are on the same plane; [49,48] used elastic springs to model surrounding tissue. Our model has the main advantage of incorporating the deformability of the graft and vein.…”

Section: Anastomosis Modelmentioning

confidence: 99%

“…However, direct measurement of these mechanical quantities in laboratory (in vivo or in vitro) are difficult and such data are not currently available in literature. Instead, the in silico approach, i.e., the Computational Fluid Dynamics (CFD) has long been applied to gauge the flow and force fields of the flow-graft-vessel system [27,28,29,30,31,32,33,34,35,36,37]. See the paper by Ene-Iordache et al [38] for a recent review on computational studies along this line.…”

Section: Introductionmentioning

confidence: 99%

“…See the paper by Ene-Iordache et al [38] for a recent review on computational studies along this line. To the best of our knowledge, in almost all of the relevant studies including the above mentioned ones except McNally et al [37], the blood vessel and AVG were assumed to be rigid and fixed. Thus the vessel/AVG radial contraction/dilation and axial compression/stretching were omitted.…”

Section: Introductionmentioning

confidence: 99%

“…Thus the vessel/AVG radial contraction/dilation and axial compression/stretching were omitted. McNally et al [37] used an elastic graft-vein model by commercial software ANSYS to study the efficacy of a novel device for reducing WSS on the vein and flow disturbance from the graft for three different flow rates.…”

Section: Introductionmentioning

confidence: 99%

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Simulation of blood flow past a distal arteriovenous-graft anastomosis at low Reynolds numbers

Bai

Zhu

2019

Physics of Fluids

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Patients with end-stage renal disease (ESRD) are usually treated by hemodialysis (HD) while waiting for kidney transplant. A common device for vascular access is arteriovenous graft (AVG). However, AVG failure induced by thrombosis has been plaguing dialysis practice for decades. Current studies indicate that the thrombosis is caused by intimal hyperplasia (IH) which is triggered by the abnormal flows and forces (e.g. wall shear stress) in the vein after AVG implant. Due to high level of complexity, in almost all of the existing works of modeling and simulation of the blood-flow vessel-AVG system the graft and blood-vessel are assumed to be rigid and immobile. Very recently we have found that the compliance of graft and vein can reduce flow disturbances and lower wall shear stress (WSS) (Z Bai and L Zhu, Computers & Fluids 181, pp. 403-415, 2019). In this paper, we apply the compliant model to investigate possible effects of several dimensionless parameters (AVG graft-vein diameter ratio R gv , AVG attaching angle θ, flow Reynolds numbers Re, and native vein speed V v ) on the flow and force fields near the distal AVG anastomosis at low Reynolds numbers (up to several hundreds). Our computational results indicate that the influences of the parameters R gv , θ, and Re lie largely on the graft and the influence of V v lies largely on the vein. In any case, the wall shear stress (WSS),

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Section: Anastomosis Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Simulation of blood flow past a distal arteriovenous-graft anastomosis at low Reynolds numbers

Bai

Zhu

2019

Physics of Fluids

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“…Therefore, the k-ω based SST turbulence model was used because of its ability to reasonably predict and resolve flow both at the wall and in the bulk flow regime. The SST turbulence model, developed by Menter, 14 was selected and is commonly used within the field [15][16][17][18][19] because it has been shown to be more accurate near the wall and in the bulk flow. It leverages blending equations that use distance from wall to determine the correct two-equation model formulation (k-ε or k-ω).…”

Section: Fsi Methodology and Model Developmentmentioning

confidence: 99%

Fluid‐structure interaction analysis of a collapsible axial flow blood pump impeller and protective cage for Fontan patients

et al. 2020

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Limited donor organs and alternative therapies have led to a growing interest in the use of blood pumps as a treatment strategy for patients with single functional ventricle. The present study examines the use of collapsible and flexible impeller, cage, and diffuser designs of an axial blood pump for Fontan patients. Using one-way fluid-structure interaction (FSI) studies, the impact of blade deformation on blood damage and pump performance was investigated for flexible impellers. We evaluated biocompatible materials, including Nitinol, Bionate 80A polyurethane, and silicone for flow rates between 2.0-4.0 L/min and rotational speeds of 3000-9000 rpm. The level of deformation experienced by a cage and diffuser made of surgical stainless steel (control), Nitinol, and Bionate 80A polyurethane was also predicted using one-way FSI. The fluid pressure on the surface of the impeller, cage, and diffuser was determined using computational fluid dynamics (CFD), and then, the surface pressure was exported and used to investigate the impeller, cage, and diffuser deformation using finite element analysis. Finally, deformed impeller geometries were imported into the CFD software to determine the implication of deformation on pressure generation, blood damage index, and fluid streamlines. It was found that rotational speed, and not flow rate, is the largest determinant of impeller deformation, occurring at the blade trailing edges. The models predicted the maximum impeller deformation for Nitinol to be 40 nm, Bionate 80A polyurethane to be 106 μm, and silicone to be 2.8 mm, all occurring at 9000 rpm. The effects of silicone deformation on performance were significant, particularly at speeds above 5000 rpm where a decrease in pressure generation of more than 10% was observed. Despite this loss, the pressure generation at 5000 rpm exceeded the level required to alleviate Fontan complications. A blood damage estimation was performed and levels remained low. The effect of significant impeller deformation on blood damage was inconsistent and requires additional investigation. Cage and diffuser geometries made of steel and Nitinol deformed minimally but Bionate 80A experienced unacceptable levels of deformation, particularly in the free-flow case without a spinning impeller. These results support the continued evaluation of a flexible, pitch-adjusting, axial-flow, mechanical assist device as a clinical therapeutic option for patients with dysfunctional Fontan physiology.

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Computational fluid-structure interaction analysis of the end-to-side radio-cephalic arteriovenous fistula

Marcinnò,

Vergara,

Giovannacci

et al. 2024

Computer Methods and Programs in Biomedicine

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Effect of arteriovenous graft flow rate on vascular access hemodynamics in a novel modular anastomotic valve device

Cited by 6 publications

References 35 publications

Simulation of blood flow past a distal arteriovenous-graft anastomosis at low Reynolds numbers

Simulation of blood flow past a distal arteriovenous-graft anastomosis at low Reynolds numbers

Fluid‐structure interaction analysis of a collapsible axial flow blood pump impeller and protective cage for Fontan patients

Computational fluid-structure interaction analysis of the end-to-side radio-cephalic arteriovenous fistula

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