Key result
Y-type graft simulation demonstrated worse long-term patency compared to normal graft, despite similar short-term hemodynamic outcomes.
Why the study?
Does a Y-type graft compared to a normal graft improve hemodynamic parameters in a computational model of coronary artery bypass grafting?
Does a Y-type graft compared to a normal graft improve hemodynamic parameters in a computational model of coronary artery bypass grafting?
Computational modeling suggests that while short-term hemodynamics are similar, Y-type CABG grafts may have worse long-term patency compared to normal grafts.
Y-type grafts may impair long-term CABG patency; leaves open clinical relevance pending human validation.
Different surgical procedures in coronary artery bypass grafting (CABG) will cause different hemodynamic environments, which will affect the surgical result and long-term patency. In this study, the hemodynamic effect of the Y-type graft was discussed by comparing it with normal graft. A patient-specific 3-dimensional (3D) model of coronary artery with serious stenosis was reconstructed. Two different surgical procedures were applied on the 3D model through the virtual surgery, the normal graft and the Y-type graft. Thus, two 3D models with different grafts were built. The zero-dimensional (0D)/3D coupling method was used to perform the numerical simulation by coupling the 3D artery model with a 0D lumped parameter model of the cardiovascular system. The coronary flow rate and the graft flow were calculated and illustrated in this paper. The wall shear stress (WSS) and oscillatory shear index (OSI) were also calculated and depicted. The short-term outcomes of the normal graft and Y-type graft are almost the same. But the long-term patency of the Y-type graft is worse. Moreover, decreasing the diameter of the graft to LCX may get higher WSS and provide enough flow at the same time.
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Zhao et al. (2015) studied Coronary artery with serious stenosis (n=1). Y-type graft vs. Normal graft was evaluated on Hemodynamic effect (coronary flow rate, graft flow, wall shear stress, and oscillatory shear index). Y-type graft simulation demonstrated worse long-term patency compared to normal graft, despite similar short-term hemodynamic outcomes.
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