Influences of Geometric Configurations of Bypass Grafts on Hemodynamics in End-to-Side Anastomosis

BACKGROUND: Although considerable efforts have been made to improve the graft patency in coronary artery bypass surgery, the role of biomechanical factors remains underrecognized. The aim of this study is to investigate the influences of geometric configurations of the bypass graft on hemodynamic characteristics in relation to anastomosis. MATERIALS AND METHODS: The Numerical analysis focuses on understanding the flow patterns for different values of inlet and distal diameters and graft angles. The Blood flow field is treated as a two-dimensional incompressible laminar flow. A finite volume method is adopted for discretization of the governing equations. The Carreau model is employed as a constitutive equation for blood. In an attempt to obtain the optimal aorto-coronary bypass conditions, the blood flow characteristics are analyzed using in vitro models of the end-to-side anastomotic angles of 45degrees, 60degrees and 90degrees. To find the optimal graft configurations, the mass flow rates at the outlets of the four models are compared quantitatively. RESULTS: This study finds that Model 3, whose bypass diameter is the same as the inlet diameter of the stenosed coronary artery, delivers the largest amount of blood and the least pressure drop along the arteries. CONCLUSION: Biomechanical factors are speculated to contribute to the graft patency in coronary artery bypass grafting.ope

Computational fluid dynamic study on effect of Carreau-Yasuda and Newtonian blood viscosity models on hemodynamic parameters

Pulsatile blood flow through the human carotid artery is studied using Computational Fluid Dynamics (CFD) in order to investigate the effect of blood rheology on the hemodynamic parameters. The carotid artery model used is segmented and reconstructed from the Magnetic Resonance Images (MRI) of a specific patient. The results of a non-Newtonian (Carreau-Yasuda) model and a Newtonian model are studied and compared. The results are represented for each peak systole where it is observed that there is significant variation in the spatial parameters between the two models considered in the study. Comparison of local shear stress magnitude in different branches namely Common Carotid Artery (CCA), Internal Carotid Artery (ICA) and External Carotid Artery (ECA) show that the shear thinning property of blood influences the Wall Shear Stress (WSS) variation. This is observed in branches where there is reduction in diameter and where the diameter reduces due to plaque deposition and also in the region where there is flow recirculation like carotid sinus

The Hatfield-System versus the Weekly Undulating Periodised Resistance Training in trained males: Effects of a third mesocyle

We recently demonstrated that recreationally strength trained men, randomly assigned to either a Hatfield-System (HAT) group or a weekly undulating periodisation (WUP) group showed significant increases in strength and power during only 2 mesocycles (6 weeks) without differences between groups. The questions arise, whether an additional mesocycle would further enhance strength and power equally or differently between groups. The same 26 strength trained men, assigned to the HAT (n = 13; age = 26.8 ± 7.2 years) or to WUP (n = 13; age = 29.2 ± 9.0 years) performed an additional mesocycle (3 weeks). Anthropometric measures and strength testing were performed again after finishing the third mesocycle and were then compared with the results recorded after the second mesocycle. Both the HAT and WUP groups made significant (p ≤ 0.05) increases in strength and power – to approximately the same extent, again, without significant differences between groups. Thus, HAT and WUP are similarly effective over a nine-week training period, and the decision to use HAT or WUP depends on the preferences of the individual athlete

Does low and oscillatory wall shear stress correlate spatially with early atherosclerosis? A systematic review

Low and oscillatory wall shear stress is widely assumed to play a key role in the initiation and development of atherosclerosis. Indeed, some studies have relied on the low shear theory when developing diagnostic and treatment strategies for cardiovascular disease. We wished to ascertain if this consensus is justified by published data. We performed a systematic review of papers that compare the localization of atherosclerotic lesions with the distribution of haemodynamic indicators calculated using computational fluid dynamics. The review showed that although many articles claim their results conform to the theory, it has been interpreted in different ways: a range of metrics has been used to characterize the distribution of disease, and they have been compared with a range of haemodynamic factors. Several studies, including all of those making systematic point-by-point comparisons of shear and disease, failed to find the expected relation. The various pre- and post-processing techniques used by different groups have reduced the range of shears over which correlations were sought, and in some cases are mutually incompatible. Finally, only a subset of the known patterns of disease has been investigated. The evidence for the low/oscillatory shear theory is less robust than commonly assumed. Longitudinal studies starting from the healthy state, or the collection of average flow metrics derived from large numbers of healthy vessels, both in conjunction with point-by-point comparisons using appropriate statistical techniques, will be necessary to improve our understanding of the relation between blood flow and atherogenesis

Simulation of fluid-structure interaction with the interface artificial compressibility method

Partitioned fluid–structure interaction simulations of the arterial system are difficult due to the incompressibility of the fluid and the shape of the domain. The interface artificial compressibility (IAC) method mitigates the incompressibility constraint by adding a source term to the continuity equation in the fluid domain adjacent to the fluid–structure interface. This source term imitates the effect of the structure's displacement as a result of the fluid pressure and disappears when the coupling iterations have converged. The IAC method requires a small modification of the flow solver but not of the black-box structural solver and it outperforms a partitioned quasi-Newton coupling of the two black-box solvers in a simulation of a carotid bifurcation. Copyright © 2009 John Wiley & Sons, Ltd

Derivation of flow related risk indices for stenosed left anterior descending coronary arteries with the use of computer simulations

The geometry of the coronary vessel network is believed to play a decisive role in the initiation, progression and outcome of coronary artery disease (CAD) and the occurrence of acute coronary syndromes (ACS). It also determines the flow field in the coronary artery which can be linked to CAD evolution. In this work geometric 3D models of left anterior descending (LAD) coronary arteries associated with either myocardial infarction (MI) or stable (STA) CAD were constructed. Transient numerical simulations of the flow for each model showed that specific flow patterns develop in different extent in the different groups examined. Recirculation zones, present distal the stenosis in all models, had larger extent and duration in MI cases. For mild stenosis (up to 50%) areas with low time averaged wall shear stress TAWSS (3 Pa) appeared only in MI models; in moderate and severe stenosis (>50%) these areas were present in all models but were significantly larger for MI than STA models. These differentiations were expressed via numerical indices based on TAWSS, oscillating shear index (OSI) and relative residence time (RRT). Additionally we introduced the coagulation activation index (CAI), based on the threshold behaviour of coagulation initiation, which exceeded the suggested threshold only for MI models with intermediate stenosis (up to 50%). These results show that numerical simulations of flow can produce arithmetic indices linked with the risk of CAD complications