Flow studies in three-dimensional aorto-right coronary bypass graft system

Sankaranarayanan, Meena; Chua, Leok Poh; Ghista, Dhanjoo N.; Tan, Yong Seng

doi:10.1080/03091900500217281

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…Richter described that flow explains the form and function of the heart and the blood vessels (16). As Richter described, the CFD model has been an important solution in achieving optimal blood flow of various configurations of CABG (16)(17)(18)(19)). The CFD model gives us useful information from the clinical point of view.…”

Section: Discussionmentioning

confidence: 99%

Computational fluid dynamic study of different incision length of coronary artery bypass grafting in a native coronary stenosis model

et al. 2019

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Background: The objective of this study was to evaluate hemodynamic patterns in end-side coronary artery bypass grafting with different anastomosis length by computational fluid dynamic study in the native coronary stenosis model. Methods: The fluid dynamic computations were carried out using ANSYS CFX. Incision length was set to be 2, 4, 6, 8, 10 mm. The angle between the two blood vessels corresponded to the length of the incision. Native vessels were set to be 90% stenosis. The radius of both native and graft vessels was set to be 2 mm. The inlet boundary condition was set by the sample of the transient time flow which was measured intraoperatively. Results: The energy efficiency was higher and energy loss was lower when the anastomosis length was longer until 8 mm. However, energy efficiency was lowest and energy loss was highest in the 10-mm model. In the 10-mm incision model, the streamline showed the scanty bypass flow in the bottom. Vortex showed that only 10-mm model showed the vortex just distal to the stenosis in the native inlet, and more vortex in native outlet than other length models. The oscillatory shear index (OSI) was higher in the outlet top in all models. And only 10-mm model showed high oscillatory index just distal to the stenosis. Conclusions: In the end-side anastomosis, an anastomosis length of 8 mm was the ideal length with less flow complexity, low OSI, and less energy loss and high energy efficiency in the native 90% stenosis model.

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Section: Discussionmentioning

confidence: 99%

Computational fluid dynamic study of different incision length of coronary artery bypass grafting in a native coronary stenosis model

et al. 2019

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“…The parameters of flow-tissueinteraction namely Wall shear stress (WSS) are very difficult to measure directly in vivo. Nevertheless they can be calculated using computational fluid dynamics (CFD) if a 3D geometric model of the vessel is available [88][89][90][91]. The geometry information can be derived from various sources including MSCT, C-Arm CT or 3D reconstructed IVUS or OCT.…”

Section: Computational Fluid Dynamics Calculations (Cfd)mentioning

confidence: 99%

New X-ray imaging modalities and their integration with intravascular imaging and interventions

Hetterich¹,

Redel

Lauritsch

et al. 2009

Int J Cardiovasc Imaging

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During recent years various techniques emerged providing more detailed images and insights in the cardiovascular system. C-Arm computed tomography is currently introduced in cardiac imaging offering the potential of three dimensional imaging of the coronary arteries, the cardiac chambers, venous system and a variety of anatomic anomalies inside the interventional environment. Furthermore it might enable perfusion imaging during percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are meanwhile established tools for detailed assessment of the coronary arteries. Their use might further increase with automated tissue characterization, three dimensional reconstruction, integration in angiography systems, and new emerging techniques. Parameters of fluid tissue interactions are important factors in the pathogenesis of atherosclerosis. These parameters can be calculated using computational fluid dynamics based on three dimensional models of the coronary vessels which can be derived from various sources including multislice computed tomography (MSCT), C-Arm CT or 3D reconstructed IVUS or OCT. Their use in the clinical setting has yet to be determined especially with regard to their ability in increasing treatment efficiency and clinical outcome.

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“…Saphenous veins grafts are connected directly to the aorta so they are exposed to large cyclic changes in the magnitude, and in some regions direction of blood flow. Regions of disturbed flow may occur in the coronary artery near the anastomosis with the SV, due to the abrupt changes in luminal areas and the angle of the union between the SV and the coronary artery [52], a topic discussed in more detail in Sec. 6.2.…”

Section: Forces Due To Hemodynamicsmentioning

confidence: 99%

Biomechanics and Mechanobiology of Saphenous Vein Grafts

Gooch

Firstenberg

Shrefler

et al. 2018

Journal of Biomechanical Engineering

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Within several weeks of use as coronary artery bypass grafts (CABG), saphenous veins (SV) exhibit significant intimal hyperplasia (IH). IH predisposes vessels to thrombosis and atherosclerosis, the two major modes of vein graft failure. The fact that SV do not develop significant IH in their native venous environment coupled with the rapidity with which they develop IH following grafting into the arterial circulation suggests that factors associated with the isolation and preparation of SV and/or differences between the venous and arterial environments contribute to disease progression. There is strong evidence suggesting that mechanical trauma associated with traditional techniques of SV preparation can significantly damage the vessel and might potentially reduce graft patency though modern surgical techniques reduces these injuries. In contrast, it seems possible that modern surgical technique, specifically endoscopic vein harvest, might introduce other mechanical trauma that could subtly injure the vein and perhaps contribute to the reduced patency observed in veins harvested using endoscopic techniques. Aspects of the arterial mechanical environment influence remodeling of SV grafted into the arterial circulation. Increased pressure likely leads to thickening of the medial wall but its role in IH is less clear. Changes in fluid flow, including increased average wall shear stress, may reduce IH while disturbed flow likely increase IH. Nonmechanical stimuli, such as exposure to arterial levels of oxygen, may also have a significant but not widely recognized role in IH. Several potentially promising approaches to alter the mechanical environment to improve graft patency are including extravascular supports or altered graft geometries are covered.

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Flow studies in three-dimensional aorto-right coronary bypass graft system

Cited by 9 publications

References 14 publications

Computational fluid dynamic study of different incision length of coronary artery bypass grafting in a native coronary stenosis model

Computational fluid dynamic study of different incision length of coronary artery bypass grafting in a native coronary stenosis model

New X-ray imaging modalities and their integration with intravascular imaging and interventions

Biomechanics and Mechanobiology of Saphenous Vein Grafts

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