Journal article
Acute Mechanical Consequences of Vessel-Specific Coronary Bypass Combinations
Cardiovascular engineering and technology, v 14(3), pp 404-418
01 Jun 2023
PMID: 36828977
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose
Premature coronary artery bypass graft (CABG) failure has been linked to geometric, mechanical, and compositional discrepancies between host and graft tissues. Acute hemodynamic disturbances and the introduction of wall stress gradients trigger a myriad of mechanobiological processes at the anastomosis that can be associated with restenosis and graft failure. Although the origins of coronary artery disease dictate the anastomotic target, an opportunity exists for graft-vessel optimization through rationale graft selection.
Methods
Here we explored the four distinct regions of the left (L) and right (R) ITA (1 = proximal, 2 = submuscular, 3 = middle, 4 = distal), and four common target vessels in the coronary circulation including the proximal and distal left anterior descending (PLAD & DLAD), right coronary (RCA), and left circumflex (LCX) arteries. Benchtop biaxial mechanical data was used to acquire constitutive model parameters of these tissues and enable vessel-specific computational models to elucidate the mechanical consequences of 32 unique graft-target combinations.
Results
Simulations revealed the maximum principal wall stresses for the PLAD, RCA, and LCX occurred when anastomosed with LITA(1), and the maximum flow-induced shear stress occurred with LITA(4). The DLAD, on the other hand, reached stress maximums when anastomosed to LITA(4). Using a normalized objective function of simulation output variables, we found LITA(2) to be the best graft choice for both LADs, RITA(3) for the RCA, and LITA(3) for the LCX.
Conclusion
Although mechanical compatibility is just one of many factors determining bypass graft outcomes, our data suggests improvements can be made to the grafting process through vessel-specific regional optimization.
Metrics
Details
- Title
- Acute Mechanical Consequences of Vessel-Specific Coronary Bypass Combinations
- Creators
- Colton J. Kostelnik - University of South CarolinaMary K. Gale - Georgia Institute of TechnologyKiersten J. Crouse - University of South CarolinaTarek Shazly - Univ South Carolina, Biomed Engn Program, Columbia, SC USAJohn F. Eberth - Drexel University, School of Biomedical Engineering, Science, and Health Systems
- Publication Details
- Cardiovascular engineering and technology, v 14(3), pp 404-418
- Publisher
- Springer Nature
- Number of pages
- 15
- Grant note
- 1760906 / Directorate For Engineering; Div Of Civil, Mechanical, & Manufact Inn; National Science Foundation (NSF); NSF - Directorate for Engineering (ENG) 1852331 / National Science Foundation (NSF) through Research Experience for Undergraduates (REU); National Science Foundation (NSF) OIA-1655740 / NSF EPSCoR; National Science Foundation (NSF); NSF - Office of the Director (OD) P20GM103641 / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA 1760906 / NSF Civil, Mechanical and Manufacturing Innovation (CMMI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000939343900002
- Scopus ID
- 2-s2.0-85148611102
- Other Identifier
- 991021861175604721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Engineering, Biomedical