title: The influence of out-of-plane geometry on the flow within a distal end-to-side anastomosis.
abstract: This paper describes a computational and experimental investigation of flow in a proto-type model geometry of a fully occluded 45 deg distal end-to-side anastomosis. Previous investigations have considered a similar configuration where the centerlines of the bypass and host vessels lie within a plane, thereby producing a plane of symmetry within the flow. We have extended these investigations by deforming the bypass vessel out of the plane of symmetry, thereby breaking the symmetry of the flow and producing a nonplanar geometry. Experimental data were obtained using magnetic resonance imaging of flow within perspex models and computational data were obtained from simulations using a high-order spectral/hp element method. We found that the nonplanar three-dimensional flow notably alters the distribution of wall shear stress at the bed of the anastomosis, reducing the peak wall shear stress peak by approximately 10 percent when compared with the planar model. Furthermore, an increase in the absolute flux of velocity into the occluded region, proximal to the anastomosis, of 80 percent was observed in the nonplanar geometry when compared with the planar geometry.
authors.affiliation: Aeronautics Department, Imperial College, London, United Kingdom.
authors.forename: S J
authors.initials: SJ
authors.lastname: Sherwin
authors.forename: O
authors.initials: O
authors.lastname: Shah
authors.forename: D J
authors.initials: DJ
authors.lastname: Doorly
authors.forename: J
authors.initials: J
authors.lastname: Peiró
authors.forename: Y
authors.initials: Y
authors.lastname: Papaharilaou
authors.forename: N
authors.initials: N
authors.lastname: Watkins
authors.forename: C G
authors.initials: CG
authors.lastname: Caro
authors.forename: C L
authors.initials: CL
authors.lastname: Dumoulin
mesh_terms: D000465:Algorithms; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D001161:Arteriosclerosis / Q000150:complications*; D015982:Bias; D003198:Computer Simulation; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000503:physiopathology*; D018056:Hemorheology; D006965:Hyperplasia; D008955:Models, Cardiovascular; D009716:Numerical Analysis, Computer-Assisted; D011673:Pulsatile Flow; D015203:Reproducibility of Results; D017539:Tunica Intima / Q000473:pathology*