title: Hydrodynamic evaluation of axillary artery perfusion for normal and diseased aorta.
abstract: Axillary artery perfusion is an attractive alternative to reduce the frequency of atheroembolism in extensive atherosclerotic aorta and aortic aneurysms. This study was conducted to evaluate the flow dynamics of axillary artery perfusion. Transparent glass models of a normal aortic arch and an aortic arch aneurysm were used to evaluate hydrodynamic properties. Streamline analysis and distribution of the shear stress was evaluated using a particle image velocity method. In the normal aortic arch model, rapid flow of 80 cm/s from the right axillary artery ran out from the brachiocephalic artery and grazed the lesser curvature of the aortic arch. There was secondary reversed flow in the ascending aorta. Flow from left axillary perfusion went straight to the descending aorta. In the aortic arch aneurysm model, flow from both axillary arteries hit the lesser curvature of the aortic arch and went into the ascending aorta with vortical flow. Distribution of shear stress was high along the jet from the ostium of the brachiocephalic artery and left subclavian artery. Flow in the aortic arch and the ascending aorta was unexpectedly rapid. Special care must be taken when the patient has frail atheroma around arch vessels or the lesser curvature of the aortic arch during axillary artery perfusion.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Minakawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Fukuda
authors.forename: Takao
authors.initials: T
authors.lastname: Inamura
authors.forename: Hideki
authors.initials: H
authors.lastname: Yanaoka
authors.forename: Kozo
authors.initials: K
authors.lastname: Fukui
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Daitoku
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hashimoto
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000502:physiology / Q000503:physiopathology*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001027:Aortography; D001366:Axillary Artery / Q000502:physiology / Q000503:physiopathology; D001783:Blood Flow Velocity; D016122:Brachiocephalic Trunk / Q000502:physiology / Q000503:physiopathology; D003198:Computer Simulation; D006439:Hemodynamics; D018056:Hemorheology; D006801:Humans; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D012016:Reference Values; D012039:Regional Blood Flow; D013314:Stress, Mechanical; D013348:Subclavian Artery / Q000502:physiology / Q000503:physiopathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed