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Analysis of blood flow in an out-of-plane CABG model

¹School of Mechanical and Aerospace Engineering and ²Bioengineering Division, Nanyang Technological University; ³Department of Cardiothoracic Surgery, National Heart Centre, Singapore; and ⁴Department of Biomedical Engineering, University of California, Irvine, California

Submitted 20 December 2005 ; accepted in final form 14 February 2006

Coronary artery bypass graft (CABG) is a routine surgical treatment for ischemic and infarcted myocardium. A large number of CABG fail postoperatively because of intimal hyperplasia within months or years. The cause of this failure is thought to be partly related to the flow patterns and shear stresses acting on the endothelial cells. An accurate representation of the flow field and associated wall shear stress (WSS) requires a detailed three-dimensional (3D) model of the CABG. The purpose of this study is to present a detailed analysis of blood flow in a 3D aorto/left CABG, bypassing the occluded left anterior descending coronary (LAD) artery. The analysis takes into account the influence of the out-of-plane geometry of the graft. The finite volume technique was employed to model the 3D blood flow pattern to determine the velocity and WSS distributions. This study presents the flow field distributions of the velocity and WSS at four instances of the cardiac cycle, two in systole and two in diastole. Our results reveal that the CABG geometry has a significant effect on the velocity distribution. The axial velocity profiles at different instances of the cardiac cycle exhibit strong skewing; significant secondary flow and vortex structures are seen in the in-plane velocity patterns. The maximum WSS on the bed of the occluded LAD artery opposite to the graft junction is 14 Pa in middiastole, whereas there is a significantly lower and more uniform distribution of WSS on the bed of the anastomosis. The present results indicate that nonplanarity of the blood vessel along with the inflow conditions has a substantial effect on the fluid mechanics of CABG that contribute to the patency of graft.

coronary artery bypass graft; three-dimensional flow; computational fluid dynamics; wall shear stress; graft patency

This article has been cited by other articles:

				Y. Huo, T. Wischgoll, and G. S. Kassab Flow patterns in three-dimensional porcine epicardial coronary arterial tree Am J Physiol Heart Circ Physiol, November 1, 2007; 293(5): H2959 - H2970. [Abstract] [Full Text] [PDF]