Key result
Simulations of bypass graft angles demonstrated high restenosis potential in coronary-coronary bypasses compared to aorto-coronary bypasses, with angles near 30 degrees yielding optimal results.
Why the study?
What is the effect of various bypass graft angles on temporal Wall Shear Stress in Aorto-Coronary and Coronary-Coronary bypasses?
What is the effect of various bypass graft angles on temporal Wall Shear Stress in Aorto-Coronary and Coronary-Coronary bypasses?
Computational modeling suggests that a bypass graft angle of approximately 30 degrees optimizes wall shear stress and may minimize restenosis risk in aorto-coronary and coronary-coronary bypasses.
Graft angle optimization may reduce restenosis risk; hypothesis-generating from level 5 simulations and requires clinical validation before practice change.
In this theoretical study, the effect of various types of bypass graft angles on the flow field, has been investigated specially on the temporal Wall Shear Stress (WSS) on the toe, heel and some locations on the bed of the Left Anterior Descending (LAD) artery at the anastomoses areas in the Aorto-Coronary (AC) and Coronary-Coronary (CC) bypasses. Flow fields in both bypasses with angles of 20o, 30o and 40o by 75% stenosis were simulated using Fluent software. The results show high restenosis potential in the side-to-end anastomosis, heel and host artery bed in the CC bypass, and also high restenosis potential at end-to-side in comparing of the AC bypass. Effects of variable graft angles on the WSS on the upper and lower heels in the CC bypass were negligible and the length of the bed influenced by variation of the graft angle was restricted to one diameter distal to the toe in AC bypass and one diameter distal to the lower toe in the CC bypass and finally use of graft angles near 30o was of other important results.
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Majid et al. (2011) studied Coronary artery stenosis. Bypass graft angles (20, 30, and 40 degrees) vs. Different angles and bypass types (Aorto-Coronary vs Coronary-Coronary) was evaluated on Temporal Wall Shear Stress (WSS). Simulations of bypass graft angles demonstrated high restenosis potential in coronary-coronary bypasses compared to aorto-coronary bypasses, with angles near 30 degrees yielding optimal results.
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