A computational fluid dynamics study pre- and post-fistula closure in a coronary artery fistula

Cao, Haoyao; Qiu, Yue; Yuan, Ding; Yu, Jianqun; Li, Da; Jiang, Yi; Su, Li; Peng, Liqing; Zheng, Tinghui

doi:10.1080/10255842.2019.1699540

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…26 A computational fluid dynamics study by Cao et al suggested that the tortuous geometry of CAFs directly contributes to worse hemodynamics within the fistula, which deteriorates following terminal closure. 27 Of note, in our…”

Section: Concerns About Procedural Complicationsmentioning

confidence: 64%

Outcomes of Transcatheter Closure of Congenital Left Circumflex Coronary Artery Fistula

Wei,

Fang,

Zhang

et al. 2024

Circ J

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outcomes following TCC of LCX-CAF and review our experience. MethodsThis retrospective study was approved by the Ethics Committee of Fuwai Hospital, Chinese Academy of Medical Sciences (No. -1126. The requirement for individual informed consent was waived due to the retrospective nature of the study and the use of anonymized data. PatientsA retrospective review was performed of all consecutive patients who were admitted to the Department of Structural Heart Disease of Fuwai Hospital and scheduled for TCC of LCX-CAF between January 2012 and December 2022. Congenital coronary artery fistulas (CAFs) are abnormal connections between the coronary arteries and major blood vessels or cardiac chambers. It has been reported that CAFs were present in 0.002-0.3% of patients who underwent invasive coronary angiography and in 0.9% of patients who underwent computed tomographic angiography. 1 Left circumflex coronary artery fistula (LCX-CAF) is a relatively rare type of CAF, with an incidence of 5-20%. 2 Transcatheter closure (TCC) of CAFs is associated with low morbidity and a favorable procedural success rate in selected patients with suitable anatomy, 3 and has recently emerged as a relatively common strategy. However, TCC of LCX-CAF is technically challenging due to the characteristics of the circumflex artery course. Despite there being a few reported cases, 4,5 information is limited regarding the outcomes of TCC of LCX-CAF. Thus, the aim of the present study was to describe

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Section: Concerns About Procedural Complicationsmentioning

confidence: 64%

Outcomes of Transcatheter Closure of Congenital Left Circumflex Coronary Artery Fistula

Wei,

Fang,

Zhang

et al. 2024

Circ J

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“…( Georgakarakos et al, 2009 ; Menichini et al, 2017 ; Bosi et al, 2018 ; García-Isla., 2018 ). In our previous studies, four patient-specific CAF models were studied using CFD ( Cao et al, 2019 , 2020 ), with conventional hemodynamics parameters such as time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) to evaluate the thrombosis risk. The results showed that a proximal occlusion to remove the terminal aneurysm may potentially reduce the post-operative thrombotic risk ( Cao et al, 2019 ), while a terminal occlusion of CAF fistula may increase the risk of thrombosis.…”

Section: Introductionmentioning

confidence: 99%

A Hemodynamic Analysis of the Thrombosis Within Occluded Coronary Arterial Fistulas With Terminal Aneurysms Using a Blood Stasis Model

et al. 2022

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Objective: The aim of this study is to numerically evaluate thrombosis risk within occluded coronary arterial fistulas (CAF) with terminal aneurysms, and provide guidance in choosing occlusion positions, with clinical observations as reference.Method: Four patients with CAF were studied, with different occlusion positions in actual treatments. Hemodynamics simulations were conducted, with blood residue predicted using the blood stasis model. Three types of models (untreated model, aneurysm-reserved model and aneurysm-removed model) were studeid for each patient. Four metrics, i.e., proportion of high oscillatory shear index (OSI), area of high OSI, old blood volume fraction (OBVF)) and old blood volume (OBV) was obtained to distinguish the thrombosis risk of different treatments (proximal or distal occlusion), comparing with the follow-up CTA.Results: For all the postopertive models, the high OBVF, high OSI(>0.3) and low time-averaged wall shear stress (TAWSS) regions were mainly at the distal fistula, indicating these regions were prone to thrombosis. The regions where blood residue remains are roughly regions of high OSI, corresponding well with clinical observations. In contrast, TAWSS failed to distinguish the difference in thrombosis risk. Absolute values (area of high OSI, OBV) can better reflect the degree of thrombosis risk between treatment types compared with percentage values (proportion of high OSI, OBVF). By comparing with the actual clinical treatments and observations, the OBV is superior to the area of high OSI in determining treatment type.Conclusion: The OBV, a volumetric parameter for blood stasis, can better account for the CAF thrombosis and reflect the degree of blood stasis compared with OSI or TAWSS, is a more appropriate metric for thrombosis in the fistula. Together with morphological parameters, the OBV could guide clinicians to formulate more appropriate surgical plans, which is of great significance for the preoperative evaluation and treatment prognosis of CAF patients.

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How Computational Model May Help in Mechanism Understanding?

Formato,

Ceserani,

Romarowski

et al. 2023

Congenital Anomalies of Coronary Arteries

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A computational fluid dynamics study pre- and post-fistula closure in a coronary artery fistula

Cited by 6 publications

References 28 publications

Outcomes of Transcatheter Closure of Congenital Left Circumflex Coronary Artery Fistula

Outcomes of Transcatheter Closure of Congenital Left Circumflex Coronary Artery Fistula

A Hemodynamic Analysis of the Thrombosis Within Occluded Coronary Arterial Fistulas With Terminal Aneurysms Using a Blood Stasis Model

How Computational Model May Help in Mechanism Understanding?

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