Validation of numerical simulation with PIV measurements for two anastomosis models.

Hemodynamics is widely believed to influence coronary artery bypass graft (CABG) stenosis. Although distal anastomosis has been extensively investigated, further studies on proximal anastomosis are still necessary, as the extent and initiation of the stenosis process may be influenced by the flow of the proximal anastomosis per se. Therefore, in this study, two models (i.e. 90 degrees and 135 degrees anastomotic models) were designed and constructed to simulate a proximal anastomosis of CABG for the left and right coronary arteries, respectively. Flow characteristics for these models were studied experimentally in order to validate the simulation results found earlier. PIV measurements were carried out on two Pyrex glass models, so that the disturbed flow (stagnation point, flow separation and vortex) found in both proximal anastomosis models using numerical simulation, could be verified. Consequently, a fair agreement between numerical and experimental data was observed in terms of flow characteristics, velocity profiles and wall shear stress (WSS) distributions under both steady and pulsatile flow conditions. The discrepancy was postulated to be due to the difference in detailed geometry of the physical and computational models, due to manufacturing limitations. It was not possible to reproduce the exact shape of the computational model when making the Pyrex glass model. The analysis of the hemodynamic parameters based on the numerical simulation study also suggested that the 135 degrees proximal anastomosis model would alleviate the potential of intimal thickening and/or atherosclerosis, more than that of a 90 degrees proximal anastomosis model, as it had a lower variation range of time-averaged WSS and the lower segmental average of WSSG.

[1]  M Ojha,et al.  Spatial and temporal variations of wall shear stress within an end-to-side arterial anastomosis model. , 1993, Journal of biomechanics.

[2]  G. Truskey,et al.  Hemodynamic parameters and early intimal thickening in branching blood vessels. , 2001, Critical reviews in biomedical engineering.

[3]  J. Watterson,et al.  Computational and experimental simulations of the haemodynamics at cuffed arterial bypass graft anastomoses , 2002, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[4]  Ulf Krüger,et al.  Flow pattern and shear stress distribution of distal end-to-side anastomoses. A comparison of the instantaneous velocity fields obtained by particle image velocimetry. , 2004, Journal of biomechanics.

[5]  D. Lyman,et al.  Effects of a vascular graft/natural artery compliance mismatch on pulsatile flow. , 1992, Journal of biomechanics.

[6]  D. L. Fry Certain Histological and Chemical Responses of the Vascular Interface to Acutely Induced Mechanical Stress in the Aorta of the Dog , 1969, Circulation research.

[7]  Michael M. Resch,et al.  Pulsatile non-Newtonian blood flow in three-dimensional carotid bifurcation models: a numerical study of flow phenomena under different bifurcation angles. , 1991, Journal of biomedical engineering.

[8]  W. Quist,et al.  Flow disturbance at the distal end-to-side anastomosis. Effect of patency of the proximal outflow segment and angle of anastomosis. , 1980, Archives of surgery.

[9]  D. Vorp Fluid mechanical considerations in vascular grafts. Overview. , 1997, ASAIO journal.

[10]  C Bertolotti,et al.  Numerical and experimental models of post-operative realistic flows in stenosed coronary bypasses. , 2001, Journal of biomechanics.

[11]  C. Kleinstreuer,et al.  Geometric design improvements for femoral graft-artery junctions mitigating restenosis. , 1996, Journal of biomechanics.

[12]  Derivation of shear rates from near-wall LDA measurements under steady and pulsatile flow conditions. , 1994, Journal of biomechanical engineering.

[13]  Richard D. Keane,et al.  Theory of cross-correlation analysis of PIV images , 1992 .

[14]  M. Walsh,et al.  On using experimentally estimated wall shear stresses to validate numerically predicted results , 2003, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[15]  D. Williams,et al.  Flow instabilities in a graft anastomosis: A study of the instantaneous velocity fields , 2001, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[16]  D. Ku,et al.  Optimal graft diameter: effect of wall shear stress on vascular healing. , 1989, Journal of vascular surgery.

[17]  H. Y. Liang,et al.  A numerical simulation of steady flow fields in a bypass tube. , 2001, Journal of biomechanics.

[18]  C Kleinstreuer,et al.  Hemodynamics analysis of a stenosed carotid bifurcation and its plaque-mitigating design. , 1991, Journal of biomechanical engineering.

[19]  Michael F. O'Rourke,et al.  McDonald's blood flow in arteries : theoretic, experimental, and clinical principles , 1990 .

[20]  Ajit P. Yoganathan,et al.  Experimental Investigation of the Steady Flow Downstream of the St. Jude Bileaflet Heart Valve: A Comparison Between Laser Doppler Velocimetry and Particle Image Velocimetry Techniques , 2004, Annals of Biomedical Engineering.

[21]  D. Steinman,et al.  A numerical simulation of flow in a two-dimensional end-to-side anastomosis model. , 1993, Journal of biomechanical engineering.

[22]  S Glagov,et al.  Hemodynamic patterns in two models of end-to-side vascular graft anastomoses: effects of pulsatility, flow division, Reynolds number, and hood length. , 1993, Journal of biomechanical engineering.

[23]  C Kleinstreuer,et al.  Relation between non-uniform hemodynamics and sites of altered permeability and lesion growth at the rabbit aorto-celiac junction. , 1999, Atherosclerosis.

[24]  C. R. Ethier,et al.  A numerical study of blood flow patterns in anatomically realistic and simplified end-to-side anastomoses. , 1999, Journal of biomechanical engineering.

[25]  D. Giddens,et al.  Pulsatile flow in an end-to-side vascular graft model: comparison of computations with experimental data. , 2001, Journal of biomechanical engineering.

[26]  D. Ku,et al.  Pulsatile flow in the human left coronary artery bifurcation: average conditions. , 1996, Journal of biomechanical engineering.

[27]  J D Thomas,et al.  The effect of angle and flow rate upon hemodynamics in distal vascular graft anastomoses: a numerical model study. , 1991, Journal of biomechanical engineering.

[28]  J. Womersley Method for the calculation of velocity, rate of flow and viscous drag in arteries when the pressure gradient is known , 1955, The Journal of physiology.

[29]  C. Kleinstreuer,et al.  Hemodynamic simulations and computer-aided designs of graft-artery junctions. , 1997, Journal of biomechanical engineering.

[30]  J. Raman,et al.  Factors affecting saphenous vein graft patency: clinical and angiographic study in 1402 symptomatic patients operated on between 1977 and 1999. , 2003, The Journal of thoracic and cardiovascular surgery.

[31]  T V How,et al.  Effects of geometry and flow division on flow structures in models of the distal end-to-side anastomosis. , 1996, Journal of Biomechanics.

[32]  S Glagov,et al.  Measurements of velocity and wall shear stress inside a PTFE vascular graft model under steady flow conditions. , 1997, Journal of biomechanical engineering.

[33]  C Kleinstreuer,et al.  Flow input waveform effects on the temporal and spatial wall shear stress gradients in a femoral graft-artery connector. , 1996, Journal of biomechanical engineering.

[34]  H. Schima,et al.  Numerical study of wall mechanics and fluid dynamics in end-to-side anastomoses and correlation to intimal hyperplasia. , 1996, Journal of biomechanics.

[35]  F. S. Henry,et al.  Numerical investigation of steady flow in proximal and distal end-to-side anastomoses. , 1996, Journal of biomechanical engineering.

[36]  ROBERT M. NEREM,et al.  Velocity Distribution and Intimal Proliferation in Autologous Vein Grafts in Dogs , 1978, Circulation research.

[37]  S Glagov,et al.  Anastomotic intimal hyperplasia: mechanical injury or flow induced. , 1992, Journal of vascular surgery.

[38]  D D Duncan,et al.  Effects of arterial compliance and non-Newtonian rheology on correlations between intimal thickness and wall shear. , 1992, Journal of biomechanical engineering.

[39]  Robert J. Lutz,et al.  The onset of turbulence in physiological pulsatile flow in a straight tube , 1998 .

[40]  L. Chua,et al.  Numerical study on the steady flow characteristics of proximal anastomotic models , 2003 .

[41]  C. Jones,et al.  Flow studies in canine artery bifurcations using a numerical simulation method. , 1992, Journal of biomechanical engineering.

[42]  Hemodynamics of a side-to-end proximal arterial anastomosis model. , 1993, Journal of vascular surgery.

[43]  E. M. Pedersen,et al.  Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses: an in vitro study. , 1996, Journal of vascular surgery.

[44]  L. Chua,et al.  Numerical Study on the Pulsatile Flow Characteristics of Proximal Anastomotic Models , 2005, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[45]  D. Steinman,et al.  The effect of wall distensibility on flow in a two-dimensional end-to-side anastomosis. , 1994, Journal of biomechanical engineering.

[46]  P. Hughes,et al.  Flow structures at the proximal side-to-end anastomosis. Influence of geometry and flow division. , 1995, Journal of biomechanical engineering.