Three-Dimensional Simulation of Coronary Artery Bypass Grafting with the Use of Computational Fluid Dynamics

Surgery Today ◽  
2000 ◽  
Vol 30 (11) ◽  
pp. 993-998 ◽  
Author(s):  
Min-Ho Song ◽  
Masaru Sato ◽  
Yuichi Ueda
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Three Dimensional ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Dimensional Simulation

Thymopericardial Augmented Encasement for Coronary Artery Bypass Graft Surgery

2009 ◽  
Vol 4 (4) ◽  
pp. 206-208
Author(s):  
Toshiya Ohtsuka ◽  
Mikio Ninomiya ◽  
Takahiro Nonaka
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Three Dimensional ◽  
Bypass Grafting ◽  
Fat Pad ◽  
Artery Bypass Grafting ◽  
Present Technique

Objective A pedicled prepericardial fat flap was created to augment the pericardial cavity and applied for patients undergoing coronary artery bypass grafting. The efficacy and durability of this method were investigated. Methods Between July 2005 and November 2008, the present technique was applied for consecutive 245 patients (165 men and 80 women, aged 67 ± 8.3 years) undergoing isolated coronary artery bypass grafting in which 240 (98.0%) were off-pump cases. The left and/or right internal thoracic artery and the gastroepiploic artery were used in 244 and 160 patients, respectively, and the saphenous vein and the radial artery were used in 51 and 10 patients, respectively. Ninety-seven (40.0%) patients had been diabetic, 18 (7.3%) had had chronic renal failure, and three were redo cases. The prepericardial soft tissue, involving the pedicled thymic gland, was dissected en bloc and sewn with pericardiotomies to wrap the heart and the grafts. Angiography or three-dimensional computed tomography was used to assess the intrapericardial pathways of each graft and a long-term durability of the fat pad. Results Early angiography or three-dimensional computed tomography proved that the graft pathways were unaffected by the encasements. Resternotomies in two patients and sternal treatments for infectious dehiscence in two patients were safely achievable. Five-year postoperative computed tomography showed the intact fat pad in the retrosternal space. Conclusions The present technique can encase the heart not the least jeopardizing each pathway of the grafts, and the durable fat pad functions protectively when the sternotomy is either reopened or infected.

Does the Ventrica Magnetic Vascular Positioner (MVP®) for Coronary Artery Bypass Grafting Significantly alter Local Fluid Dynamics? a Numeric Study

2007 ◽  
Vol 30 (7) ◽  
pp. 628-639 ◽  
Author(s):  
U. Morbiducci ◽  
M. Lemma ◽  
R. Ponzini ◽  
A. Boi ◽  
L. Bondavalli ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Beating Heart ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Wall Shear

Objective Automatic devices have been recently introduced to make the anastomosis procedure quick and efficient when creating a coronary bypass on the beating heart. However, the implantation of these devices could modify the graft configuration, consistently affecting the hemodynamics usually found in the traditional anastomosis. As local fluid dynamics could play a significant role in the onset of vessel wall pathologies, in this article a computational approach was designed to investigate flow patterns in the presence of the Ventrica magnetic vascular positioner (Ventrica MVP®) device. Methods A model of standard hand-sewn anastomosis and of automated magnetic anastomosis were constructed, and the finite volume method was used to simulate in silico realistic graft hemodynamics. Synthetic analytical descriptors - i.e., time-averaged wall shear stress (TAWSS), oscillating shear index (OSI) and helical flow index (HFI) - were calculated and compared for quantitative assessment of the anastomosis geometry hemodynamic performance. Results In this case study, the same most critical region was identified for the 2 models as the one with the lowest TAWSS and the highest OSI (TAWSS=0.229, OSI=0.255 for the hand-sewn anastomosis; TAWSS=0.297, OSI=0.171 for the Ventrica MVP®). However, the shape of the Ventrica MVP® does not induce more critical wall shear stresses, oscillating flow and damped helicity in the graft fluid dynamics, as compared with conventional anastomosis. Conclusions We found that the use of the Ventrica MVP® for the case study under investigation was not associated with more critical fluid dynamics than with conventional hand-sewn anastomosis. Thereby, the device could facilitate beating heart and minimally invasive coronary artery bypass grafting without increasing local hemodynamic-related risks of failure. (Int J Artif Organs 2007; 30: 628–39)

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