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Numerical investigation of blood flow in a sequential aorto-coronary bypass graft model
Meena S1, Dhanjoo N Ghista, Leok Poh Chua
1Media Division, Institute for Infocomm Research, Nanyang Technological University, Singapore. meena@i2r.a-star.edu.sg
Insights
A side-to-side anastomosis in coronary artery bypass grafting (CABG) shows better blood flow and graft patency compared to end-to-side configurations. This study analyzed flow patterns and wall shear stress in 3D CABG models.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Fluid Dynamics
Background:
- Sequential grafting is used for blocked or narrowed coronary arteries.
- Coronary artery bypass graft (CABG) anastomosis configuration impacts blood flow.
- Understanding flow dynamics is crucial for improving graft patency.
Purpose of the Study:
- To investigate the influence of anastomosis configuration on blood flow in a 3D CABG model.
- To determine how different anastomosis types affect velocity and wall shear stress (WSS) distributions.
Main Methods:
- Utilized the finite volume technique to model 3D blood flow patterns.
- Analyzed velocity and WSS distributions at two cardiac cycle instances (start of ejection and early diastole).
- Compared end-to-side and side-to-side anastomosis configurations.
Main Results:
- Maximum wall shear stress (WSS) was observed at the 'toe' of the end-to-side anastomosis.
- Side-to-side anastomosis regions exhibited smooth flow patterns.
- Side-to-side anastomosis resulted in nearly uniform WSS variation.
Conclusions:
- Side-to-side anastomosis configuration is associated with improved graft patency.
- End-to-side anastomosis may lead to suboptimal flow dynamics and WSS.
- Anastomosis design significantly influences CABG outcomes.
Abstract:
Sequential grafting technique is adopted when one or more of the coronary arteries are blocked or severely narrowed. The objective of this study was to understand the influence of the anastomosis configuration on the blood flow in the three-dimensional coronary artery bypass graft (CABG) model. The finite volume technique was employed to model the 3-D blood flow pattern to determine the velocity and WSS distributions. This study presents the flow-field distributions of the velocity and WSS at two instances of the cardiac cycle, one during start of ejection (t=0.0 s) and the other during early diastole (t=0.32 s). Our results reveal that maximum wall shear stress was observed at the toe of the end-to side anastomosis. The smooth flow patterns observed in the side-to-side anastomosis region resulted in an almost uniform variation of WSS. The present work indicates that a side-to-side anastomosis would result in a better graft patency than an end-to-side anastomosis.
