title: Impact of competitive flow on hemodynamics in coronary surgery: numerical study of ITA-LAD model.
abstract: Competitive flow from native coronary artery is considered as a major factor in the failure of the coronary artery bypass grafts. However, the physiological effects are not very clear. The aim is to research the impact of competitive flow caused by different left anterior descending (LAD) artery stenosis degrees on hemodynamics in internal thoracic artery (ITA) bypass graft. An idealized ITA-LAD model was built in CAD tools. The degree of the competitive flow was divided into five classes according to different LAD stenosis degrees: higher (no stenosis), secondary (30% stenosis), reduced (50% stenosis), lower (75% stenosis) and no competitive flow (fully stenosis). Finite volume method was employed for the numerical simulation. The flow velocity distributions, wall shear stress and oscillatory shear index were analyzed. Results showed that higher competitive flow in the bypass graft would produce unbeneficial wall shear stress distribution associating with endothelial dysfunction and subsequent graft failure. The coronary bypass graft surgery was preferred to be carried out when the LAD stenosis was higher than 75%.
authors.affiliation: College of Life Science and Bioengineering, Beijing University of Technology, Beijing 100124, China.
authors.forename: Jinli
authors.initials: J
authors.lastname: Ding
authors.forename: Youjun
authors.initials: Y
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.forename: Fan
authors.initials: F
authors.lastname: Bai
mesh_terms: D001158:Arteries / Q000473:pathology; D013504:Cardiovascular Surgical Procedures; D019295:Computational Biology / Q000379:methods; D003198:Computer Simulation; D003251:Constriction, Pathologic; D001026:Coronary Artery Bypass / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008323:Mammary Arteries / Q000473:pathology; D008953:Models, Anatomic; D015233:Models, Statistical; D008962:Models, Theoretical; D013314:Stress, Mechanical; D013895:Thoracic Arteries / Q000601:surgery