Hydrodynamics of aortic cannulae during extracorporeal circulation in a mock aortic arch aneurysm model.

This study was designed to analyze flow pattern, velocity, and strain on the aortic wall of a glass aortic arch aneurysm model during the extracorporeal circulation, and to elucidate the characteristics of flow pattern in three different aortic cannulae. Different patterns of large vortices and helical flow were made by each cannula. With the curved end-hole cannula, the high velocity flow (approximately 0.6-0.8 m/s) was blowing to the aneurismal wall without attenuating the strain rate tensor (approximately 0.2-0.25/s). With the dispersion cannula and the Soft-Flow cannula, cannular jet was attenuated in the ascending aorta creating a large vortex at a velocity less than 0.5 m/s, and the strain rate tensor on the aneurismal wall was small (less than 0.15/s). In conclusion, end-hole cannula should not be used in the operation of aortic arch aneurysm. Dispersion-type aortic cannulae were less invasive on the aortic arch aneurismal wall, but particular attention to alternative cannulation sites should be paid in cases with severe atherosclerosis on the ascending aortic wall.

Experimental fluid dynamics of transventricular apical aortic cannulation.

To clarify the flow pattern from a transventricular apical aortic cannula, hydrodynamic analysis of transventricular apical aortic cannulation (apical cannulation) was performed using particle-image velocimetry in a glass aortic model. Simulated apical cannulation using a 7-mm Sarns Soft-Flow cannula and the newly developed 7-mm apical aortic cannula was compared with standard aortic cannulation. The flow-velocity, streamline, and distribution of magnitude of the strain rate tensor (function of shear stress) were analyzed. Streamline analysis revealed a steady and organized flow profile in apical cannulation as compared with that in standard aortic cannulation. The magnitude of the strain rate tensor decreased within a few centimeters from the exit of the apical cannula.

Computer-simulated fluid dynamics of arterial perfusion in extracorporeal circulation: From reality to virtual simulation.

BACKGROUND: Atheroembolism due to aortic manipulation remains an unsolved problem in surgery for thoracic aortic aneurysm. The goal of the present study is to create a computer simulation (CS) model with which to analyze blood flow in the diseased aorta. METHOD: A three-dimensional glass model of the aortic arch was constructed from CT images of a normal, healthy person and a patient with transverse aortic arch aneurysm. Separately, a CS model of the curved end-hole cannula was created, and flow from the aortic cannula was recreated using a numerical simulation. RESULTS: Comparison of the data obtained by the glass model analyses revealed that the flow velocity and the vector of the flow around the exit of the cannula were similar to that in the CS model. A high-velocity area was observed around the cannula exit in both the glass model and the CS model. The maximum flow velocity was as large as 1.0 m/s at 20 mm from the cannula exit and remained as large as 0.5 to 0.6 m/s within 50 mm of the exit. In the aortic arch aneurysm models, the rapid jet flow from the cannula moved straight toward the lesser curvature of the transverse aortic arch. The locations and intensities of the calculated vortices were slightly different from those obtained for the glass model. CONCLUSION: The proposed CS method for the analysis of blood flow from the aortic cannulae during extracorporeal circulation can reproduce the flow velocity and flow pattern in the proximal and transverse aortic arches.

Effect of cannula shape on aortic wall and flow turbulence: hydrodynamic study during extracorporeal circulation in mock thoracic aorta.

This study was designed to analyze flow pattern, velocity, and strain on the aortic wall of a glass aortic model during extracorporeal circulation, and to elucidate the characteristics of flow pattern in four aortic cannulas. Different patterns of large vortices and helical flow were made by each cannula. The high-velocity flow (0.6 m/s) was observed in end-hole cannula, causing high strain rate tensor (0.3~0.4 without unit) on the aortic arch. In dispersion cannula, a decreased strain rate tensor (less than 0.1) was found on the outer curvature of the aortic arch. In Soft-flow cannula (3M Cardiovascular, Ann Arbor, MI, USA), further decreased flow velocity (0.2 m/s) and strain (less than 0.2) were observed. In Select 3D cannula (Medtronic, Inc., Minneapolis, MN, USA), a high strain (0.4~0.5) was observed along the inner curvature of the aortic arch. In conclusion, end-hole cannula should not be used in atherosclerotic aorta. Particular attention should be paid both for selection of cannulas and cannulation site based on this result.

Flow velocity and turbulence in the transverse aorta of a proximally directed aortic cannula: hydrodynamic study in a transparent model.

BACKGROUND: The objective of this study was to visualize and characterize the effect of cannula tip direction on flow within transverse aortic arch. METHODS: A hydrodynamic analysis of the Dispersion arterial cannula (Edwards Lifescience LLC, Irvine, CA) was performed using particle image velocimetry in glass perfusion models of healthy and aneurysmal aortic arches. Flow velocity, streamline, distribution of magnitude of the strain rate tensor (function of shear stress), and degree of flow turbulence were comparatively analyzed for cannula tip directed toward the aortic arch (standard direction) and toward the aortic root (root direction). RESULTS: Standard direction cannulation in the model of the healthy aorta showed the flow velocity in the transverse aortic arch was rapid, the streamlines were nonlinear, and the magnitude of the strain rate tensor was high along aortic curvatures. Conversely, directing the cannula tip toward the aortic root generated slower and less turbulent flow in the transverse aortic arch despite high velocity and turbulence and nonlinear streamlines in the ascending aorta. In the aneurysmal aortic arch model, the flow velocity was more rapid in the area where aortic arch vessels originated, and a reversely directed vortex was observed between the aneurysm and the origination of the arch vessels. In the root direction model, the flow velocity distribution was slower than that in the standard direction. CONCLUSIONS: Directing the cannula tip of the Dispersion cannula toward the aortic root generated slower and less turbulent flow in the transverse arch of the glass models of both healthy and aneurysmal aortic arches.

Hydrodynamic evaluation of axillary artery perfusion for normal and diseased aorta.

Axillary artery perfusion is an attractive alternative to reduce the frequency of atheroembolism in extensive atherosclerotic aorta and aortic aneurysms. This study was conducted to evaluate the flow dynamics of axillary artery perfusion. Transparent glass models of a normal aortic arch and an aortic arch aneurysm were used to evaluate hydrodynamic properties. Streamline analysis and distribution of the shear stress was evaluated using a particle image velocity method. In the normal aortic arch model, rapid flow of 80 cm/s from the right axillary artery ran out from the brachiocephalic artery and grazed the lesser curvature of the aortic arch. There was secondary reversed flow in the ascending aorta. Flow from left axillary perfusion went straight to the descending aorta. In the aortic arch aneurysm model, flow from both axillary arteries hit the lesser curvature of the aortic arch and went into the ascending aorta with vortical flow. Distribution of shear stress was high along the jet from the ostium of the brachiocephalic artery and left subclavian artery. Flow in the aortic arch and the ascending aorta was unexpectedly rapid. Special care must be taken when the patient has frail atheroma around arch vessels or the lesser curvature of the aortic arch during axillary artery perfusion.