| Numerical study of hemodynamics and wall mechanics in distal end-to-side anastomoses of bypass grafts. | |
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MedLine Citation:
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PMID: 11784541 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The development and progress of distal anastomotic intimal hyperplasia seems to be promoted by altered flow conditions and intramural stress distributions at the region of the artery-graft junction of vascular bypass configurations. From clinical observations, it is known that intimal hyperplasia preferentially occurs at outflow anastomoses of prosthetic bypass grafts. In order to gain a deeper insight into post-operative disease processes, and subsequently, to contribute to the development of improved vascular reconstructions with respect to long term patency rates, detailed studies are required. In context with in vivo experiments, this study was designed to analyze the flow dynamics and wall mechanics in anatomically correct bypass configurations related to two different surgical techniques and resulting geometries (conventional geometry and Miller-cuff). The influence of geometric conditions and of different compliance of synthetic graft, the host artery and the interposed venous cuff on the hemodynamic behavior and on the wall stresses are investigated. The flow studies apply the time-dependent, three-dimensional Navier-Stokes equations describing the motion of an incompressible Newtonian fluid. The vessel walls are described by a geometrically non-linear shell structure. In an iterative coupling procedure, the two problems are solved by means of the finite element method. The numerical results demonstrate non-physiological flow patterns in the anastomotic region. Strongly skewed axial velocity profiles and high secondary velocities occur downstream the artery-graft junction. On the artery floor opposite the junction, flow separation and zones of recirculation are found. The wall mechanical studies show that increased compliance mismatch leads to increased intramural stresses, and thus, may have a proliferative influence on suture line hyperplasia, as it is observed in the in vivo study. |
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Authors:
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Armin Leuprecht; Karl Perktold; Martin Prosi; Thomas Berk; Wolfgang Trubel; Heinrich Schima |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of biomechanics Volume: 35 ISSN: 0021-9290 ISO Abbreviation: J Biomech Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-01-10 Completed Date: 2002-04-09 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0157375 Medline TA: J Biomech Country: United States |
Other Details:
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Languages: eng Pagination: 225-36 Citation Subset: IM |
Affiliation:
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Institute of Mathematics, Technical University Graz, Steyrergasse 30/3, A-8010 Graz, Austria. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical
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methods* Animals Biomechanics Blood Flow Velocity Blood Vessel Prosthesis Compliance Coronary Artery Bypass* Coronary Circulation* Coronary Vessels / pathology, physiopathology Finite Element Analysis Heart / physiopathology* Hemodynamics Hyperplasia Models, Cardiovascular* Polytetrafluoroethylene Sheep Stress, Mechanical Tunica Intima / pathology |
| Chemical | |
Reg. No./Substance:
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9002-84-0/Polytetrafluoroethylene |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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