Comparative hydrodynamic evaluation of variants of cavapulmonary anastomosis
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Coaxial and angular shift of anastomosis have significant effects on the flow rate distribution, size and location of recirculation zones, and zones of vortex formation or congestion.
To reduce the hemodynamic complications caused by blood flow distortion, the CCPA anastomosis is recommended to be made at an angle of 60±5° to the RPA axis and with a 0.5d±0.1d axial shift.
If the anastomosis is shifted by more than 0.5d, a steady state macrovortex is formed at the central area of the CCPA. The vortex is a closed recirculation zone (three-dimensional coil) capable of complete obstruction of the blood vessel lumen.
Inadequately applied anastomosis may cause blood flow destructurization, increase the probability of hemolysis, ischemia, and thrombogenesis, and provoke postoperative arrhythmia caused by flow rate pulsations.
KeywordsVortex Ischemia Rate Pulsation Recirculation Zone Rate Distribution
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