Computational fluid dynamics simulation of the right subclavian artery cannulation

Area of Science:

• Cardiovascular Science
• Medical Imaging
• Fluid Dynamics

Background:

• Cannulation strategies for cardiopulmonary support are critical.
• Understanding blood flow in patient-specific aortic arch anatomy is essential for optimizing perfusion.
• Computational fluid dynamics (CFD) offers a powerful tool for simulating complex hemodynamics.

Purpose of the Study:

• To evaluate the efficacy and hemodynamic impact of right subclavian artery cannulation.
• To compare right subclavian artery cannulation with ascending aorta cannulation using CFD.
• To assess the influence of different aortic arch geometries on cannulation outcomes.

Main Methods:

• Patient-specific aortic arch models were created from CT images, including normal, ascending aorta aneurysm, distal arch aneurysm, and bovine arch patterns.
• CFD simulations were performed to model pulsatile flow under various cannulation strategies (right subclavian artery vs. ascending aorta) and flow rates (50%, 75%, 100%).
• Three-dimensional flow visualization was used to analyze blood streamlines and perfusion patterns throughout the cardiac cycle.

Main Results:

• Right subclavian artery cannulation resulted in retrograde brachiocephalic artery flow and antegrade right common carotid artery flow, while directing flow towards the descending aorta.
• Left-side supra-aortic branches received perfusion from both the right subclavian artery cannula and the aortic valve.
• Ascending aorta cannulation demonstrated that aortic valve flow reached all supra-aortic vessels during systole.

Conclusions:

• Right subclavian artery cannulation demonstrates cerebroprotective potential, especially for the right cerebral circulation.
• CFD analysis provides valuable insights into the hemodynamic consequences of different arterial cannulation strategies.
• The findings support the consideration of right subclavian artery cannulation for specific clinical scenarios requiring cerebral protection.