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Computational fluid dynamics simulate optimal design of segmental arteries reattachment: Influence of blood flow stagnationCentral MessagePerspective

Authors :
Yuki Ikeno, MD, PhD
Yoshishige Takayama, MEng
Michael L. Williams, MD
Yujiro Kawaniashi, MD, PhD
Paul Jansz, MD, PhD
Source :
JTCVS Open, Vol 15, Iss , Pp 61-71 (2023)
Publication Year :
2023
Publisher :
Elsevier, 2023.

Abstract

Objectives: This study aimed to simulate blood flow stagnation using computational fluid dynamics and to clarify the optimal design of segmental artery reattachment for thoracoabdominal aortic repair. Methods: Blood flow stagnation, defined by low-velocity volume or area of the segmental artery, was simulated by a 3-dimensional model emulating the systolic phase. Four groups were evaluated: direct anastomosis, graft interposition, loop-graft, and end graft. Based on contemporary clinical studies, direct anastomosis can provide a superior patency rate than other reattachment methods. We hypothesized that stagnation of the blood flow is negatively associated with patency rates. Over time, velocity changes were evaluated. Results: The direct anastomosis method led to the least blood flow stagnation, whilst the end-graft reattachment method resulted in worse blood flow stagnation. The loop-graft method was comparatively during late systole, which was also influenced by configuration of the side branch. Graft interposition using 20 mm showed a low-velocity area in the distal part of the side graft. When comparing length and diameter of an interposed graft, shorter and smaller branches resulted in less blood flow stagnation. Conclusions: In our simulation, direct anastomosis of the segmental artery resulted in the most efficient design in terms of blood flow stagnation. A shorter (

Details

Language :
English
ISSN :
26662736
Volume :
15
Issue :
61-71
Database :
Directory of Open Access Journals
Journal :
JTCVS Open
Publication Type :
Academic Journal
Accession number :
edsdoj.b295518f1224b7db85c5be60e201d97
Document Type :
article
Full Text :
https://doi.org/10.1016/j.xjon.2023.07.008