Analysis of Computational Fluid Dynamics and Particle Image Velocimetry Models of Distal-End Side-to-Side and End-to-Side Anastomoses for Coronary Artery Bypass Grafting in a Pulsatile Flow

Background:Intimal hyperplasia (IH) is a major cause of graft failure. Hemodynamic factors such as stagnation and disturbed blood flow are involved in IH formation. The aim of this study is to perform a comparative analysis of distal-end side-to-side (deSTS) and end-to-side (ETS) anastomoses using c...

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Bibliographic Details
Published in:Circulation Journal 2017/12/25, Vol.82(1), pp.110-117
Main Authors: Shintani, Yoshiko, Iino, Kenji, Yamamoto, Yoshitaka, Kato, Hiroki, Takemura, Hirofumi, Kiwata, Takahiro
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Computational fluid dynamics
Coronary Artery Bypass - methods
Coronary artery bypass grafting
Distal-end side-to-side anastomosis
Humans
Hydrodynamics
Hyperplasia
Intimal hyperplasia
Models, Cardiovascular
Particle image velocimetry
Pulsatile Flow
Rheology - methods
Tunica Intima - pathology
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Summary:Background:Intimal hyperplasia (IH) is a major cause of graft failure. Hemodynamic factors such as stagnation and disturbed blood flow are involved in IH formation. The aim of this study is to perform a comparative analysis of distal-end side-to-side (deSTS) and end-to-side (ETS) anastomoses using computational fluid dynamics (CFD) after validating the results via particle image velocimetry (PIV).Methods and Results:We investigated the characteristics of our target flow fields using CFD under steady and pulsatile flows. CFD via PIV under steady flow in a 10-times-actual-size model was validated. The CFD analysis revealed a recirculation zone in the heel region in the deSTS and ETS anastomoses and at the distal end of the graft, and just distal to the toe of the host artery in the deSTS anastomoses. The recirculation zone sizes changed with the phase shift. We found regions of low wall shear stress and high oscillating shear index in the same areas. The PIV and CFD results were similar.Conclusions:It was demonstrated that the hemodynamic characteristics of CFD and PIV is the difference between the deSTS and ETS anastomoses; that is, the deSTS flow peripheral to the distal end of the graft, at the distal end and just distal to the toe of the host artery is involved in the IH formation.
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-17-0381