Analysis of Flow Through Extra-Anatomic Bypasses Between Supra-Aortic Branches Using Particle Image Velocimetry (PIV).

Supra-aortic extra-anatomic debranch (SAD) are prosthetic surgical grafts used to revascularize head and neck arteries that would be blocked during a surgical or hybrid procedure used in treating ascending and arch of the aorta pathologies. However, bypassing the supra-aortic arteries but not occlud...

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Published in:Clinical Medicine Insights: Cardiology pp. 1 - 12
Main Authors: Williamson, Petra N., Docherty, Paul D., Khanafer, Adib, Steven, Briana M.
Format: equations & formulas pictorial research tables/charts Journal Article
Published: Sage Publications Inc. 3/4/2024
Online Access:View this record in EBSCOhost
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      jtl: Clinical Medicine Insights: Cardiology
      issn: 11795468
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    pubinfo:
      dt: 3/4/2024
      pid: 344
      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        10.1177/11795468231221413
        175872728
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        atl: Analysis of Flow Through Extra-Anatomic Bypasses Between Supra-Aortic Branches Using Particle Image Velocimetry (PIV).
      aug:
        au:
          Williamson, Petra N.
          Docherty, Paul D.
          Khanafer, Adib
          Steven, Briana M.
        affil: Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand
      sug:
        subj:
          Prosthesis Design
          Aorta, Thoracic Surgery
          Aneurysm, Dissecting Surgery
          Brachiocephalic Trunk Surgery
          Cardiac Surgery Methods
          Hemodynamics
          Rheology
          Human
          Models, Biological
          Blood Flow Velocity
          Blood Vessel Prosthesis Methods
          Descriptive Statistics
      ab: Supra-aortic extra-anatomic debranch (SAD) are prosthetic surgical grafts used to revascularize head and neck arteries that would be blocked during a surgical or hybrid procedure used in treating ascending and arch of the aorta pathologies. However, bypassing the supra-aortic arteries but not occluding their orifice might introduce potential for competitive flow that reduces bypass patency. Competitive flow within the bypasses across the supra-aortic arteries has not previously been identified. This research identified haemodynamics due to prophylactic inclusion of bypasses from the brachiocephalic artery (BCA) to the left common carotid artery (LCCA), and from the LCCA to left subclavian artery (LSA). Four model configurations investigated the risk of competitive flow and the necessity of intentionally blocking the proximal LSA and/or LCCA. Particle image velocimetry (PIV) was used to assess haemodynamics in each model configuration. We found potential for competitive flow in the BCA-LCCA bypass when the LSA was blocked, in the LSA-LCCA bypass, when the LCCA alone or LCCA and LSA were blocked. Flow stagnated at the start of systole within the RCCA-LCCA bypass, along with notable recirculation zones and reciprocating flow occurring throughout systolic flow. Flow also stagnated in the LCCA-LSA bypass when the LCCA was blocked. There was a large recirculation in the LCCA-LSA bypass when both the LCCA and LSA were blocked. The presence of competitive flow in all other configurations indicated that it is necessary to block or ligate the native LCCA and LSA once the debranch is made and the thoracic endovascular aortic repair (TEVAR) completed.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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