Human Saphenous Vein Coronary Artery Bypass Graft Morphology, Geometry and Hemodynamics
Human Saphenous Vein Coronary Artery Bypass Graft Morphology, Geometry and Hemodynamics
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DOI：
10.1007/s10439-005-1732-z
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发表时间：
2005-03
影响因子：
3.8
通讯作者：
R. Leask;J. Butany;K. Johnston;C. Ethier;M. Ojha
中科院分区：
文献类型：
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作者：
R. Leask;J. Butany;K. Johnston;C. Ethier;M. Ojha
冠状动脉旁路移植术（CABG）失败与移植物血流动力学，特别是壁面切应力有关。本研究描述了人冠状动脉旁路的形态学、几何学和壁面切应力模式。应用数字光学显微镜对49例人大隐静脉冠状动脉旁路移植术（CABG）的内膜厚度（IT）进行了测量。通过死后输注巴特森#17解剖腐蚀铸造化合物，复制了6个隐静脉CABG的几何形状。在稳态（Re = 110）和脉动流（Re = 110，α = 2）条件下，在由铸件制成的两种流动模型中评价了移植物血流动力学。平均而言，原位大隐静脉CABG超过2个月时，远端吻合口的帽和缝合部位的IT最大。帽盖、缝合部位和移植物主体处的地板增厚差异很大，并且明显小于IT。所有铸件均显示沿地板有沿着凹陷，5/6铸件显示罩上有明显的局部弯曲。在这两种流动模型中，壁面剪切速率的大幅度增加发生在发动机罩上，就在近端的脚趾。罩的局部几何形状在壁面剪切应力中产生了较大的空间梯度，这可能是罩内膜增生的一个因素。
Coronary artery bypass graft (CABG) failure has been linked to graft hemodynamics, in particular wall shear stress. This study characterizes the morphology, geometry and wall shear stress patterns in human CABGs. The intimal thickness (IT) in 49 human saphenous vein CABGs was measured by digital light microscopy. The geometry of six saphenous vein CABGs was replicated by post-mortem infusion of Batson’s #17 anatomical corrosion casting compound. Graft hemodynamics were evaluated in two flow models, fabricated from the casts, under steady (Re = 110) and pulsatile flow (Re = 110, α = 2) conditions. Saphenous vein CABGsin situfor more than 2 months had, on average, the greatest IT on the hood and suture sites of the distal anastomosis. Floor thickening was highly variable and significantly less than IT at the hood, suture site and graft body. All casts showed an indentation along the floor and 5/6 casts displayed a sharp local curvature on the hood. In both flow models, a large increase in wall shear rate occurred on the hood, just proximal to the toe. The local geometry of the hood created this large spatial gradient in wall shear stress which is a likely factor in hood intimal hyperplasia.