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- Title
Hemodynamic analysis of sequential graft from right coronary system to left coronary system.
- Authors
Wenxin Wang; Boyan Mao; Haoran Wang; Xueying Geng; Xi Zhao; Huixia Zhang; Jinsheng Xie; Zhou Zhao; Bo Lian; Youjun Liu; Wang, Wenxin; Mao, Boyan; Wang, Haoran; Geng, Xueying; Zhao, Xi; Zhang, Huixia; Xie, Jinsheng; Zhao, Zhou; Lian, Bo; Liu, Youjun
- Abstract
<bold>Background: </bold>Sequential and single grafting are two surgical procedures of coronary artery bypass grafting. However, it remains unclear if the sequential graft can be used between the right and left coronary artery system. The purpose of this paper is to clarify the possibility of right coronary artery system anastomosis to left coronary system.<bold>Methods: </bold>A patient-specific 3D model was first reconstructed based on coronary computed tomography angiography (CCTA) images. Two different grafts, the normal multi-graft (Model 1) and the novel multi-graft (Model 2), were then implemented on this patient-specific model using virtual surgery techniques. In Model 1, the single graft was anastomosed to right coronary artery (RCA) and the sequential graft was adopted to anastomose left anterior descending (LAD) and left circumflex artery (LCX). While in Model 2, the single graft was anastomosed to LAD and the sequential graft was adopted to anastomose RCA and LCX. A zero-dimensional/three-dimensional (0D/3D) coupling method was used to realize the multi-scale simulation of both the pre-operative and two post-operative models.<bold>Results: </bold>Flow rates in the coronary artery and grafts were obtained. The hemodynamic parameters were also showed, including wall shear stress (WSS) and oscillatory shear index (OSI). The area of low WSS and OSI in Model 1 was much less than that in Model 2.<bold>Conclusions: </bold>Model 1 shows optimistic hemodynamic modifications which may enhance the long-term patency of grafts. The anterior segments of sequential graft have better long-term patency than the posterior segments. With rational spatial position of the heart vessels, the last anastomosis of sequential graft should be connected to the main branch.
- Subjects
HEMODYNAMICS; CORONARY arteries; TRANSPLANTATION of organs, tissues, etc.; COMPUTED tomography; ANGIOGRAPHY; ABDOMINAL aortic aneurysms; ARTERIES; BIOLOGICAL models; BIOMECHANICS; COMPUTER simulation; CORONARY artery bypass; PRESSURE; SURGICAL stents; THROMBOSIS; THREE-dimensional imaging; PHYSIOLOGIC strain; RELATIVE medical risk
- Publication
BioMedical Engineering OnLine, 2016, Vol 15, p545
- ISSN
1475-925X
- Publication type
journal article
- DOI
10.1186/s12938-016-0259-x