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Hemodynamics of Coronary Artery Bypass Grafting: Conventional vs. Innovative Anastomotic Configuration Designs for Enhancing Patency

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Coronary Graft Failure

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Abstract

In this chapter, we have reviewed (1) coronary arterial bypass grafting hemodynamics and (2) anastomosis designs to improve graft patency. The chapter specifically addresses the biomechanical factors for enhancement of the patency of coronary artery bypass grafts (CABGs). Stenosis of distal anastomosis, caused by thrombosis and intimal hyperplasia (IH), is the major cause of failure of CABGs. Strong correlations have been established between (1) the hemodynamics and vessel wall biomechanical factors and (2) the initiation and development of IH and thrombus formation. Accordingly, several investigations have been conducted and numerous anastomotic geometries and devices have been designed to better regulate the blood flow fields and distribution of hemodynamic parameters and biomechanical factors at the distal anastomosis, in order to enhance the patency of CABGs. Enhancement of longevity and patency rate of CABGs can eliminate the need for reoperation and can significantly lower morbidity, and thereby reduces medical costs for patients suffering from coronary stenosis. This chapter focuses on various endeavors made thus far to design a patency-enhancing optimized anastomotic configuration for the distal junction of CABGs.

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Authors and Affiliations

  1. Department of Biomedical Engineering, The University of Michigan, Ann Arbor, MI, USA

    Foad Kabinejadian PhD

  2. University 2020 Foundation, Northborough, MA, USA

    Dhanjoo N. Ghista PhD

  3. Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore

    Mercedeh Kaabi Nezhadian BEng & Hwa Liang Leo PhD

Authors
  1. Foad Kabinejadian PhD
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  2. Dhanjoo N. Ghista PhD
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  3. Mercedeh Kaabi Nezhadian BEng
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  4. Hwa Liang Leo PhD
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Correspondence to Foad Kabinejadian PhD .

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Editors and Affiliations

  1. Cardiology, Army's Center for Cardiovascular Di, Bucharest, Romania

    Ion C. Ţintoiu

  2. Department of Surgery, Chinese University of Hong Kong, Sha Tin, Hong Kong

    Malcolm John Underwood

  3. University Fribourg, Hospital HFR Fribourg, Fribourg, Fribourg, Switzerland

    Stephane Pierre Cook

  4. Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan

    Hironori Kitabata

  5. University Medical Center, Texas Tech Univ. Health Science Center, EL PASO, Texas, USA

    Aamer Abbas

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Kabinejadian, F., Ghista, D.N., Nezhadian, M.K., Leo, H.L. (2016). Hemodynamics of Coronary Artery Bypass Grafting: Conventional vs. Innovative Anastomotic Configuration Designs for Enhancing Patency. In: Ţintoiu, I., Underwood, M., Cook, S., Kitabata, H., Abbas, A. (eds) Coronary Graft Failure. Springer, Cham. https://doi.org/10.1007/978-3-319-26515-5_35

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