Comput Math Methods Med - Impact of competitive flow on hemodynamics in coronary surgery: numerical study of ITA-LAD model.

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Resumo

Competitive flow from native coronary artery is considered as a major factor in the failure of the coronary artery bypass grafts. However, the physiological effects are not very clear. The aim is to research the impact of competitive flow caused by different left anterior descending (LAD) artery stenosis degrees on hemodynamics in internal thoracic artery (ITA) bypass graft. An idealized ITA-LAD model was built in CAD tools. The degree of the competitive flow was divided into five classes according to different LAD stenosis degrees: higher (no stenosis), secondary (30% stenosis), reduced (50% stenosis), lower (75% stenosis) and no competitive flow (fully stenosis). Finite volume method was employed for the numerical simulation. The flow velocity distributions, wall shear stress and oscillatory shear index were analyzed. Results showed that higher competitive flow in the bypass graft would produce unbeneficial wall shear stress distribution associating with endothelial dysfunction and subsequent graft failure. The coronary bypass graft surgery was preferred to be carried out when the LAD stenosis was higher than 75%.

Resumo Limpo

competit flow nativ coronari arteri consid major factor failur coronari arteri bypass graft howev physiolog effect clear aim research impact competit flow caus differ left anterior descend lad arteri stenosi degre hemodynam intern thorac arteri ita bypass graft ideal italad model built cad tool degre competit flow divid five class accord differ lad stenosi degre higher stenosi secondari stenosi reduc stenosi lower stenosi competit flow fulli stenosi finit volum method employ numer simul flow veloc distribut wall shear stress oscillatori shear index analyz result show higher competit flow bypass graft produc unbenefici wall shear stress distribut associ endotheli dysfunct subsequ graft failur coronari bypass graft surgeri prefer carri lad stenosi higher

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