Patient-specific hemodynamics of new coronary artery bypass configurations

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dc.authoridŞenol Pişkin / 0000-0002-8799-9472en_US
dc.authorscopusidŞenol Pişkin / 8636421200
dc.authorwosidŞenol Pişkin / JYJ-00 63-2024
dc.contributor.authorRezaeimoghaddam, Mohammad
dc.contributor.authorOguz, Gokce Nur
dc.contributor.authorAtes, Mehmet Sanser
dc.contributor.authorAlkan Bozkaya, Tijen
dc.contributor.authorPişkin, Şenol
dc.contributor.authorLashkarinia, S Samaneh
dc.contributor.authorTenekecioglu, Erhan
dc.contributor.authorKaragoz, Haldun
dc.contributor.authorPekkan, Kerem
dc.date.accessioned2020-10-20T08:14:41Z
dc.date.available2020-10-20T08:14:41Z
dc.date.issued2020en_US
dc.departmentİstinye Üniversitesi, Mühendislik ve Doğa Bilimleri Fakültesi, Makine Mühendisliği Bölümüen_US
dc.description.abstractPurpose: This study aims to quantify the patient-specific hemodynamics of complex conduit routing configurations of coronary artery bypass grafting (CABG) operation which are specifically suitable for off-pump surgeries. Coronary perfusion efficacy and local hemodynamics of multiple left internal mammary artery (LIMA) with sequential and end-to-side anastomosis are investigated. Using a full anatomical model comprised of aortic arch and coronary artery branches the optimum perfusion configuration in multi-vessel coronary artery stenosis is desired. Methodology: Two clinically relevant CABG configurations are created using a virtual surgical planning tool where for each configuration set, the stenosis level, anastomosis distance and angle were varied. A non-Newtonian computational fluid dynamics solver in OpenFOAM incorporated with resistance boundary conditions representing the coronary perfusion physiology was developed. The numerical accuracy is verified and results agreed well with a validated commercial cardiovascular flow solver and experiments. For segmental performance analysis, new coronary perfusion indices to quantify deviation from the healthy scenario were introduced. Results: The first simulation configuration set;-a CABG targeting two stenos sites on the left anterior descending artery (LAD), the LIMA graft was capable of 31 mL/min blood supply for all the parametric cases and uphold the healthy LAD perfusion in agreement with the clinical experience. In the second end-to-side anastomosed graft configuration set;-the radial artery graft anastomosed to LIMA, a maximum of 64 mL/min flow rate in LIMA was observed. However, except LAD, the obtuse marginal (OM) and second marginal artery (m2) suffered poor perfusion. In the first set, average wall shear stress (WSS) were in the range of 4 to 35 dyns/cm2 for in LAD. Nevertheless, for second configuration sets the WSS values were higher as the LIMA could not supply enough blood to OM and m2. Conclusion: The virtual surgical configurations have the potential to improve the quality of operation by providing quantitative surgical insight. The degree of stenosis is a critical factor in terms of coronary perfusion and WSS. The sequential anastomosis can be done safely if the anastomosis angle is less than 90 degrees regardless of degree of stenosis. The smaller proposed perfusion index value, O(0.04 - 0) × 102, enable us to quantify the post-op hemodynamic performance by comparing with the ideal healthy physiological flow.en_US
dc.identifier.citationRezaeimoghaddam, M., Oguz, G. N., Ates, M. S., Bozkaya, T. A., Piskin, S., Samaneh Lashkarinia, S., Tenekecioglu, E., Karagoz, H., & Pekkan, K. (2020). Patient-Specific Hemodynamics of New Coronary Artery Bypass Configurations. Cardiovascular engineering and technology, 10.1007/s13239-020-00493-9. Advance online publication. https://doi.org/10.1007/s13239-020-00493-9en_US
dc.identifier.doi10.1007/s13239-020-00493-9en_US
dc.identifier.isbn1869-408X
dc.identifier.pmid33051831en_US
dc.identifier.scopus2-s2.0-85092509869en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.urihttps://doi.org/10.1007/s13239-020-00493-9
dc.identifier.urihttps://hdl.handle.net/20.500.12713/1146
dc.identifier.wosWOS:000578330300001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorPişkin, Şenol
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofCardiovasc Eng Technolen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCoronary Artery Bypass Graftingen_US
dc.subjectHemodynamicsen_US
dc.subjectSequential Graften_US
dc.subjectSurgical Planningen_US
dc.titlePatient-specific hemodynamics of new coronary artery bypass configurationsen_US
dc.typeArticleen_US

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