Amal Owida

Numerical analysis of coronary artery bypass grafts: An over view

Arterial bypass grafts tend to fail after some years due to the development of intimal thickening (restenosis). Non-uniform hemodynamics following a bypass operation contributes to restenosis and bypass failure can occur due to the focal development of anastomotic intimal hyperplasia. Additionally, surgical injury aggravated by compliance mismatch between the graft and artery has been suggested as an initiating factor for progress of wall thickening along the suture line Vascular grafts that are small in diameter tend to occlude rapidly. Computational fluid dynamics (CFD) methods have been effectively used to simulate the physical and geometrical parameters characterizing the hemodynamics of various arteries and bypass configurations. The effects of such changes on the pressure and flow characteristics as well as the wall shear stress during a cardiac cycle can be simulated. Recently, utilization of fluid and structure interactions have been used to determine fluid flow parameters and structure forces including stress and strains relationships under steady and transient conditions. In parallel to this, experimental diagnostics techniques such as Laser Doppler Anemometry, Particle Image Velocimetry, Doppler Guide wire and Magnetic Resonance Imaging have been used to provide essential information and to validate the numerical results. Moreover, clinical imaging techniques such as magnetic resonance or computed tomography have assisted considerably in gaining a detailed patient-specific picture of the blood flow and structure dynamics. This paper gives a review of recent numerical investigations of various configurations of coronary artery bypass grafts (CABG). In addition, the paper ends with a summary of the findings and the future directions.

Artery vessel fabrication using the combined fused deposition modeling and electrospinning techniques

Purpose – The purpose of this paper is to prepare a new combined method of rapid prototyping, fused deposition modeling (FDM) and electrospinning for the fabrication of coronary artery bypass graft (CABG).Design/methodology/approach – A dynamically optimum design of blood vessel graft was constructed using FDM and electrospinning. Fabrication of 3‐D CABG model was constructed using pro‐engineer based on the optimum hemodynamic analysis and was converted to an stereolithography file format which was imported to the Magic software where it was edited to a high‐resolution contour. The model was then created from acrylonitrile butadiene styrene which was used as a collector for electrospinning fabrication. For the electrospinning thermoplastic polyurethane was dissolved with hexafluoroisopropanol. The voltage applied for electrospinning was 15 kV where the solid FDM model was used to collect nanofibers at fixed distance.Findings – The properties of the fabricated vessel agreed well with those of human artery....

PIV measurements and numerical validation of end-to-side anastomosis

In this article, particle image velocimetry (PIV) technique was used to determine the instantaneous velocity fields inside a model of end-to-side anastomosis under various physiological flow conditions. Using ANSYS software, a three-dimensional (3D) computational model at the peak systolic blood flow was simulated. The numerical and experimental results were presented and discussed in terms of velocity fields at various locations along the graft and the host artery. The numerical results were then compared with the experimental data and a large difference was found, which was attributed to the imperfection of manufacturing the glass model and measurements error associated with PIV. The findings indicated in general that the analysis at peak systole, steady flow could help in providing essential quantitative information of the hemodynamics in anastomotic artery.

Biomimetic electrospun gelatin-chitosan polyurethane for heart valve leaflets

Native heart valve leaflets are subjected to continuous pulsatile and homodynamic forces and can be as thin as 300 μm. For a proper function of the valve the materials selected for the leaflets need to be biocompatible, robust, flexible, and have comparable mechanical properties to the natural ones. In this paper, biocompatibility and cell retention ability for gelatin–chitosan polyurethane (PU), polyglycolide (PGA)/PLA and collagen-coated bovine pericardium were examined and their mechanical properties were tested. Endothelial cells, isolated from ovine carotid arteries were seeded onto these materials and exposed to a range of shear-stresses for a period of 1–3 h. The findings indicated that throughout the exposure time and the shear-stress range tested, a mean cell retention rate of 80% was obtained in the gelatin–chitosan PU group. However, for PGA/PLA and pericardium groups it was found that as the exposure time of shear-stress increased, a significant cell reduction was observed. Noticeably for all the range of physiological flow conditions tested, the electrospun gelatin–chitosan PU demonstrated good biocompatibility and cell retention properties and could be potentially used as a biomaterial for tissue engineering of heart valves.

INTIMAL HYPERPLASIA AND WALL SHEAR IN ARTERIAL BYPASS Y-GRAFTING AND CONSEQUENCE GRAFTING: A NUMERICAL STUDY

The progression of intimal hyperplasia is considered to be the main cause of bypass failure and is directly related to the individual blood rheology, local arterial geometry and placement of the junctions, graft diameter and graft surface characteristics as well as the degree of compliance. In this paper we use commercial computational fluid dynamics (CFD) ANSYS to examine under the correct physiological flow conditions the hemodynamic forces of composite bypass with internal mammary artery in Y-grafting and consequence grafting which is known to achieve high patency rate and highly recommended by clinicians. Particular emphasis is given here on the parameters that could initiate the development of intimal hyperplasia within these bypass configurations. The hemodynamic flow patterns between the consequence grafting and the composite Y-grafting are observed here to be different. Moreover, on both end-to-side and side-to-side configurations, the circulating flows are detected in the vicinity of the junction area, while the Dean flow vortexes are only observed on the end-to-side configuration. Likewise, the hemodynamic flow on the end-to-side configuration on the LCX of both 45° and 90° Y-grafting is found to be smoother than that of the junction on the LCA, regardless of the changing of anastomosis angles. The high WSS gradients are observed at the vicinity of the toe and on the bed of the junction, while the low WSS are presented at the distal of the stenosis and at the stagnation point. The clinical relevance of the results are presented and discussed with particular focus on the factors and the flow patterns that trigger the development of intimal hyperplasia.

Graft–Artery Junctions: Design Optimization and CAD Development

Designing and manufacturing of vascular prosthesis for arterial bypass grafts is a very complex problem. The process involves the selection of suitable geometry, materials of appropriate characteristics, and manufacturing technique capable of constructing prosthesis in a cost-effective manner. In this chapter, all engineering aspects related to the design and optimization of an artificial graft are presented and discussed. These aspects include CAD design of the graft, in vitro hemodynamic analysis to ensure good mechanical integrity and functionality, and optimization of the manufacturing techniques. Brief discussion is also given on the endothelization and vascularization of the artificial vessels and the future directions of the development of synthetic vessels for human implementation.

Electrospinning of nanofibres for construction of vital organ replacements

This paper described the production of a novel biosynthetic material using the manufacturing technique of electro spinning for the construction of scaffold for organ replacement. This electrostatic technique uses an electric field to control the deposition of polymer fibres onto a specific substrate to fabricate fibrous polymer constructs composed of fibre diameters ranging from several microns down to 100 nm or less. Two areas of research, in particular, heart valve leaflets and blood vessel will be discussed. Here, a sandwich structure nanofibre mesh was used to construct materials for leaflets of heart valve and blood vessel. In the case of heart valve leaflet, the randomly oriented polyurethane nanofibres were prepared as the first layer, followed by gelatin-chitosan complex layer. Complex nanofibres were initially used to spin on the PU layer with cross orientation to mimic the fibrosa layer. A gelatin and chitosan complex was then spun onto the other side of PU nanofibre mesh to mimic the ventricularis layer. This particular sandwich structure using the PU layer was designed to simulate the mechanical properties of natural tissue. In addition, this design was aimed to provide good biocompatibility and improved cellular environment to assist in adhesion and proliferation. Smooth muscle cells adhered and flattened out onto the surface of the gelatin-chitosan complex as early as 1 day post seeding. There is great potential for this biosynthetic biocompatible nanofibrous material to be developed for various clinical applications.