scholarly journals Development of an In Vitro Model to Characterize the Effects of Transcatheter Aortic Valve on Coronary Artery Flow

2015 ◽  
Vol 40 (6) ◽  
pp. 612-619 ◽  
Author(s):  
Joseph Calderan ◽  
Wenbin Mao ◽  
Eric Sirois ◽  
Wei Sun
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
In Vitro Model ◽  
Transcatheter Aortic Valve ◽  
Coronary Artery Flow ◽  
Vitro Model ◽  
Artery Flow

In Vitro Investigation of the Impact of Aortic Valve Stenosis Severity on Left Coronary Artery Flow

2010 ◽  
Vol 132 (4) ◽  
Author(s):  
E. Gaillard ◽  
D. Garcia ◽  
L. Kadem ◽  
P. Pibarot ◽  
L.-G. Durand
Keyword(s):  
Coronary Artery ◽  
Angina Pectoris ◽  
Aortic Valve ◽  
Coronary Flow ◽  
Left Coronary Artery ◽  
In Vitro Model ◽  
Coronary Circulation ◽  
Physiological Conditions ◽  
Vitro Model

Patients with aortic valve stenosis (AS) may experience angina pectoris even if they have angiographically normal coronary arteries. Angina is associated with a marked increase in the risk of sudden death in AS patients. Only a few in vitro models describing the interaction between the left ventricular and aortic pressures, and the coronary circulation have been reported. These models were designed for specific research studies and they need to be improved or modified when other specific studies are required. Consequently, we have developed an in vitro model that is able to mimic the coronary circulation in presence of aortic stenosis. First, we have validated the model under physiological conditions. Then, we have examined and quantified the hemodynamic effects of different degrees of AS (from normal to severe AS) on the coronary flow using a model of the normal left coronary artery. In the coronary in vitro model without AS (normal valve), the amplitude and shape of coronary flow were similar to those observed in in vivo measurements obtained under physiological conditions, as described by Hozumi et al. (1998, “Noninvasive Assessment of Significant Left Anterior Descending Coronary Artery Stenosis by Coronary Flow Velocity Reserve With Transthoracic Color Doppler Echocardiography,” Circulation, 97, pp. 1557–1562). The presence of an AS induced an increase in the maximum and mean coronary flow rates (97% and 73%, respectively, for a very severe AS). Furthermore, when AS was very severe, a retrograde flow occurred during systole. This study allowed us to validate our coronary in vitro model under physiological conditions, both in the absence and presence of AS. These changes could explain the fact that even if patients have angiographically normal epicardial coronary arteries, we can observe the occurrence of angina pectoris in these patients in the presence of an AS.

Platelet Adhesion/Aggregation in an In Vitro Model of Coronary Artery Stenosis

1991 ◽  
Vol 26 ◽  
pp. S101-S102
Author(s):  
ERIC F. GRABOWSKI ◽  
SONAM L. McDONNELL ◽  
COLE THOMSON ◽  
MARISOL RODRIGUEZ
Keyword(s):  
Coronary Artery ◽  
In Vitro Model ◽  
Platelet Adhesion ◽  
Coronary Artery Stenosis ◽  
Artery Stenosis ◽  
Vitro Model

In Vitro Pressure Flow Relationship in Model of Significant Coronary Artery Stenosis

2004 ◽  
Author(s):  
Abhijit Sinha Roy ◽  
Lloyd H. Back ◽  
Ronald W. Millard ◽  
Saeb Khoury ◽  
Rupak K. Banerjee
Keyword(s):  
Coronary Artery ◽  
Pressure Drop ◽  
Power Law ◽  
Flow Rate ◽  
In Vitro Model ◽  
Maximum Pressure ◽  
Vitro Model ◽  
Maximum Pressure Drop

Simultaneous measurement of pressure and flow rate has been found to be helpful in evaluating the physiologic significance of obstructive coronary artery disease and in the diagnosis of microvascular disease. This experimental study seeks to find important pressure-flow relationship in an in-vitro model of significant coronary artery stenoses using a non-Newtonian liquid, similar to blood showing a shear thinning behavior, using significant stenotic in-vitro model (minimal area stenosis = 90%). The geometry for the stenotic model is based on data provided in an in vivo study by Wilson et al., (1988). For 90% area stenosis, the maximum recorded pressure drop for steady flow rate of 55, 79 and 89 are 14, ~24 and ~32 mmHg respectively. The maximum pressure drop at flow rate of 115 ml/min (the physiological limit) is 50.3 mmHg respectively. Using a power law curve fit, the maximum pressure drop (in mmHg) related with flow rate (in ml/min) provided a power law index of 1.72. Shorter distal length than required in the in-vitro model did not allow the recording of complete pressure recovery. This preliminary data provides reference values for further experimentation both in vitro with pulsatile flow as in physiological conditions, and in vivo.

scholarly journals To Balloon or Not to Balloon? The Effects of an Intra-Aortic Balloon-Pump on Coronary Artery Flow during Extracorporeal Circulation Simulating Normal and Low Cardiac Output Syndromes

2021 ◽  
Vol 10 (22) ◽  
pp. 5333
Author(s):  
Philippe Reymond ◽  
Karim Bendjelid ◽  
Raphaël Giraud ◽  
Gérald Richard ◽  
Nicolas Murith ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Coronary Artery ◽  
Coronary Blood Flow ◽  
Low Cardiac Output ◽  
Coronary Artery Flow ◽  
Artery Flow

ECMO is the most frequently used mechanical support for patients suffering from low cardiac output syndrome. Combining IABP with ECMO is believed to increase coronary artery blood flow, decrease high afterload, and restore systemic pulsatile flow conditions. This study evaluates that combined effect on coronary artery flow during various load conditions using an in vitro circuit. In doing so, different clinical scenarios were simulated, such as normal cardiac output and moderate-to-severe heart failure. In the heart failure scenarios, we used peripheral ECMO support to compensate for the lowered cardiac output value and reach a default normal value. The increase in coronary blood flow using the combined IABP-ECMO setup was more noticeable in low heart rate conditions. At baseline, intermediate and severe LV failure levels, adding IABP increased coronary mean flow by 16%, 7.5%, and 3.4% (HR 60 bpm) and by 6%, 4.5%, and 2.5% (HR 100 bpm) respectively. Based on our in vitro study results, combining ECMO and IABP in a heart failure setup further improves coronary blood flow. This effect was more pronounced at a lower heart rate and decreased with heart failure, which might positively impact recovery from cardiac failure.

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