Noninvasive Quantification of Blood Flow in Epicardial Coronary Arteries, Coronary Artery Bypass Grafts, and Anastomoses
T. Bruce FergusonCheng ChenSunghan KimKenneth M. JacobsZhiyong PengZhen ZhuAshesh N. BuchJeffery C. Basham
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Coronary arteries
As the type of anastomotic site is considered to be one of the decisive factors for graft-patency in coronary artery bypass grafting(CABG),our aim is to achieve anastomosis forms that potentially promote long-term graft-patency rates. When an arterial graft is used, side-to-side anastomosis is performed, with its incision length being longer than that of the coronary artery, to achieve a cuff-like anastomosis form. When a vein graft is used, on the other hand, it is incised shorter than the coronary artery to achieve a skirt-like anastomosis form instead of a purse-like one. It is thus expected that reliable anastomosis forms can be observed in postoperative angiography.
Cuff
Surgical anastomosis
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Objective:To reveal the direct sign of competitive blood flow between the Left Internal Mammary Artery(LIMA) graft and native Left Anterior Descending artery(LAD).To summarize the flow dynamics characteristics.To find the reason of competitive blood flow and clinical significance.Methods:75 patient who had undergone coronary artery bypass grafting(CABG) were examined by color Doppler of coronary flow imaging(CDCFI) and peripheral blood vessel ultrasound almost 1 week postoperatively.The proximal and distal of the LIMA graft,anastomosis,and proximal and distal LAD were examined.Results:7 patients have competitive blood flow after CABG.Both LAD and LIMA graft showed mainly antegrade flow by CDCFI.The proximal portion of the LIMA showed a dominant systolic flow pattern by Ultrasound.Conclusion:CDCFI could reveal the direct sign of competitive blood flow between LIMA graft and native LAD.It could provide the evi-dence of indication of CABG if Summed up the reason of competitive blood flow.
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A A A A AA A A A A A A A A AA A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A A A A A A A A A A A A AA A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A
Sudden Death
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Coronary arteries
Circumflex
Lumen (anatomy)
Left coronary artery
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128 human hearts including 70 males and 58 females in all age groups were used for the present study. Coronary arteries were dissected out from all the human hearts. The luminal diameter was studied in all the four major coronary arteries, namely, right coronary artery (RCA), left coronary artery (LCA), left anterior descending artery (LAD) and left circumflex coronary artery (LCX) in both the sexes. The histological sections were stained with H & E stain and the diameter was measured with the help of ocular micrometer. Among the four major coronary arteries luminal diameter is found to be more in LCA followed by LAD, RCA and LCX. Luminal diameter was found to be more in males as compared to females in all the four major coronary arteries. The data of present study can be useful for doing any instrumentation of coronary artery.
Coronary arteries
Circumflex
Left coronary artery
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The heart is covered with arteries that also known as the coronary artery which in blood vessel the oxygenated blood from the lungs is being transferred to the heart. The blood flow in human arterial system can be considered as a fluid dynamics problem. Simulation of blood flow in the coronary artery will provide a better understanding of the physiology of human body. The simulation also gives the doctors to predict the behaviour of the coronary artery blood flow to avoid any unwanted problems. The main objective of the project was to demonstrate and stimulate the blood flow in the coronary artery by using a Computational Fluid Dynamic (CFD) modelling approach. The simulation used software ANSYS Fluent 18.2 which provide us with the details of the behaviour of the blood flow. The steps of achieving the simulation will be shown in the report and also the parameters used for the simulation such as density of blood, viscosity of blood and the shear stress on the wall of the vessel. The project aims to see the effect of coronary artery bypass graft (CABG) with length 9mm and 10.5 mm towards the right coronary artery with plaque blocked within the artery simulation. The project will be stimulated the changes of velocity of the blood flow in the RCA.
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Coronary arteries
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Sudden Death
Clustering coefficient
Socialization
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Sutureline blood flow was measured with laser Doppler velocimetry in colonic anastomoses created with the stapler, manual suturing, or a combination. Blood flow was always reduced in the sutureline compared with normal mucosa. Of all the anastomoses studied, tight stapling reduced sutureline blood flow the most, whereas the two-layered manual anastomosis or stapling reinforced with sutures were somewhat less ischemic. Stapling adjusted to bowel wall thickness impaired flow only moderately. It was possible with practice to outperform the stapler by single-layered manual anastomosis using fine sutures. In humans, stapled ileocolostomy had a higher suture-line blood flow than the two-layered manual anastomosis. In view of the existing clinical experience of safe stapling without adjustment for bowel wall thickness, a low sutureline blood flow is probably tolerated to a considerable degree in humans. However, this study clearly shows that tight stapling can reduce sutureline blood flow unduly, whereas superior blood supply can be attained by attention to staple closure height relative to bowel wall thickness.
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Suction type stabilizers are popular for off-pump coronary artery bypass. However, arteries running deeply underneath fatty tissue are not stabilized well because the soft tissues act as cushions between the coronary artery and the stabilizer. We propose a simple method to stabilize and visualize intra fat coronary arteries. After dissection of target arteries, 5-0 polypropylene continuous over-and-over sutures are placed on the fat tissues along both sides of the coronary artery. These sutures are pulled laterally, and a suction stabilizer is placed so that the sutures lie under the legs of the stabilizer. Sutures fixed to the stabilizer legs with suction force reduce motion of the target vessel. Visualization of the coronary arteries is also improved because the banks of fat tissue become flat by pulling the sutures laterally.
Coronary arteries
Stabilizer (aeronautics)
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