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Flow waveform effects on end-to-side anastomotic flow patterns

C R Ethier1, D A Steinman, X Zhang

  • 1Department of Mechanical and Industrial Engineering, University of Toronto, Institute of Biomedical Engineering, Ont., Canada. ethier@mie.utoronto.ca

Journal of Biomechanics
|October 31, 1998
PubMed
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Coronary artery bypass grafts may experience less intimal hyperplasia than peripheral grafts due to lower wall shear stress gradients. This finding could help identify factors promoting graft failure after surgery.

Area of Science:

  • Biomedical Engineering
  • Cardiovascular Research
  • Fluid Dynamics

Background:

  • Anastomotic intimal hyperplasia is a primary cause of arterial bypass graft failure.
  • Hemodynamic factors, particularly abnormal wall shear stress (WSS), are implicated in promoting hyperplasia.
  • Understanding WSS patterns is crucial for improving graft patency.

Purpose of the Study:

  • To quantify the impact of different flow waveforms on peri-anastomotic hemodynamics.
  • To analyze the resulting wall shear stress patterns at the anastomosis.
  • To investigate the influence of flow waveform on WSS gradients.

Main Methods:

  • Numerical computation of blood flow and WSS in a 3D anastomosis model.
  • Utilized human femoral, iliac, and coronary artery flow waveforms.

Related Experiment Videos

  • Validated numerical results against experimental data.

    • Main Results:

    • Peri-anastomotic WSS patterns are shaped by secondary flows and flow unsteadiness.
    • Peripheral (iliac, femoral) waveforms generated significant temporal and spatial WSS gradients.
    • Coronary waveforms resulted in 2-3 times lower normalized bed WSS gradients compared to peripheral waveforms.

    Conclusions:

    • Lower WSS gradients in coronary bypass grafts suggest reduced intimal hyperplasia compared to peripheral grafts.
    • Findings support the hypothesis that high WSS gradients promote anastomotic intimal hyperplasia.
    • Further studies correlating WSS with histopathology can elucidate specific promoting factors.