Document Detail


Pulsatile extracorporeal circulation during on-pump cardiac surgery enhances aortic wall shear stress.
MedLine Citation:
PMID:  22035639     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Controversy on superiority of pulsatile versus non-pulsatile extracorporeal circulation in cardiac surgery still continues. Stroke as one of the major adverse events during cardiopulmonary bypass is, in the majority of cases, caused by mobilization of aortic arteriosclerotic plaques that is inducible by pathologically elevated wall shear stress values. The present study employs computational fluid dynamics to evaluate the aortic blood flow and wall shear stress profiles under the influence of antegrade or retrograde perfusion with pulsatile versus non-pulsatile extracorporeal circulation. While, compared to physiological flow, a non-pulsatile perfusion resulted in generally decreased blood velocities and only moderately increased shear forces (48Pa versus 20Pa antegradely and 127Pa versus 30Pa retrogradely), a pulsatile perfusion extensively enhanced the occurrence of turbulences, maximum blood flow speed and maximum wall shear stress (1020Pa versus 20Pa antegradely and 1178Pa versus 30Pa retrogradely). Under these circumstances arteriosclerotic embolism has to be considered. Further simulations and experimental work are necessary to elucidate the impact of our findings on the scientific discourse of pulsatile versus non-pulsatile extracorporeal circulation.
Authors:
Alexander Assmann; Ali Cemal Benim; Fethi Gül; Philipp Lux; Payam Akhyari; Udo Boeken; Franz Joos; Peter Feindt; Artur Lichtenberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-27
Journal Detail:
Title:  Journal of biomechanics     Volume:  -     ISSN:  1873-2380     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Clinic for Cardiovascular Surgery, Heinrich Heine University Medical School, Moorenstr. 5, D-40225 Duesseldorf, Germany.
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