Impact of competitive flow on wall shear stress in coronary surgery: computational fluid dynamics of a LIMA–LAD model
| Autor: | Dag Nordhaug, Håvard Nordgaard, Idar Kirkeby-Garstad, Rune Haaverstad, Abigail Swillens, Lasse Lovstakken, Patrick Segers, Denis Van Loo, Nicola Vitale |
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| Rok vydání: | 2010 |
| Předmět: |
Swine
Physiology Computational fluid dynamics VIVO Wall shear stress Fluid dynamics Medicine Coronary Artery Bypass Endothelial dysfunction CABG Anastomosis Surgical Models Cardiovascular Graft patency TERM PATENCY Science General Coronary Vessels INTERMEDIATE surgical procedures operative medicine.anatomical_structure Models Animal Circulatory system cardiovascular system Cardiology Shear Strength Cardiology and Cardiovascular Medicine Blood Flow Velocity circulatory and respiratory physiology Competitive flow medicine.medical_specialty Endothelium Internal thoracic artery BYPASS GRAFT DISEASE INTERNAL THORACIC ARTERY STENOSIS Shear strength (soil) Physiology (medical) medicine.artery Internal medicine Shear stress Animals Mammary Arteries business.industry medicine.disease SEVERITY ATHEROSCLEROSIS Flow (mathematics) Regional Blood Flow PATTERNS Hydrodynamics Endothelium Vascular Stress Mechanical business |
| Zdroj: | CARDIOVASCULAR RESEARCH |
| ISSN: | 1755-3245 0008-6363 |
| Popis: | Competitive flow from native coronary vessels is considered a major factor in the failure of coronary bypass grafts. However, the pathophysiological effects are not fully understood. Low and oscillatory wall shear stress (WSS) is known to induce endothelial dysfunction and vascular disease, like atherosclerosis and intimal hyperplasia. The aim was to investigate the impact of competitive flow on WSS in mammary artery bypass grafts. Using computational fluid dynamics, WSS was calculated in a left internal mammary artery (LIMA) graft to the left anterior descending artery in a three-dimensional in vivo porcine coronary artery bypass graft model. The following conditions were investigated: high competitive flow (non-significant coronary lesion), partial competitive flow (significant coronary lesion), and no competitive flow (totally occluded coronary vessel). Time-averaged WSS of LIMA at high, partial, and no competitive flow were 0.3-0.6, 0.6-3.0, and 0.9-3.0 Pa, respectively. Further, oscillatory WSS quantified as the oscillatory shear index (OSI) ranged from (maximum OSI = 0.5 equals zero net WSS) 0.15 to 0.35, < 0.05, and < 0.05, respectively. Thus, high competitive flow resulted in substantial oscillatory and low WSS. Moderate competitive flow resulted in WSS and OSI similar to the no competitive flow condition. Graft flow is highly dependent on the degree of competitive flow. High competitive flow was found to produce unfavourable WSS consistent with endothelial dysfunction and subsequent graft narrowing and failure. Partial competitive flow, however, may be better tolerated as it was found to be similar to the ideal condition of no competitive flow. |
| Databáze: | OpenAIRE |
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