Influence of Aortic Outflow Cannula Orientation on Epiaortic Flow Pattern During Pulsed Cardiopulmonary Bypass

Caruso, Maria Vittoria; Gramigna, Vera; Serraino, Giuseppe Filiberto; Renzulli, Attilio; Fragomeni, Gionata

doi:10.1007/s40846-015-0053-4

Cited by 14 publications

(9 citation statements)

References 29 publications

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“…A 57-year-old male computed tomography (CT) images were used for the geometrical aortic modelling (data provided by The Prince Charles Hospital, Rode Rd, Brisbane). 29 The Queensland University of Technology Human Research Ethics Committee assessed this research which meets waivered consent conditions (exemption: 1,800,000,122).…”

Section: Methodsmentioning

confidence: 99%

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Effect of aortic cannulation depth on air emboli transport during cardiopulmonary bypass: A computational study

McDonald

Pauls

et al. 2022

Perfusion

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Introduction Varying the insertion depth of the aortic cannula during cardiopulmonary bypass (CPB) has been investigated as a strategy to mitigate cerebral emboli, yet its effectiveness associated with CPB flow is not fully understood. We compared different arterial cannula insertion depths and pump flow influencing air microemboli entering the aortic arch branch arteries (AABA). Methods A computational approach used a patient-specific aorta model to evaluate four cannula locations at (1) proximal arch, (2) mid arch, (3) distal arch, and (4) descending aorta. We injected 0.1 mm microemboli (N=720) at 2 and 5 L/min and assessed the embolic load and the particle averaged transit times ( entering the AABA. Results Location 4 had the lowest embolic load (2 L/min: N= 63) and (5 L/min: N= 54) compared to locations 1 to 3 in the range of (N= 118 to 116 at 2 L/min:) and (N= 92 to 146 at 5 L/min). There was no significant difference between 2 L/min and 5 L/min (p = 0.31), despite 5 L/min attaining a lower mean (±standard deviation) than 2 L/min (38.0±23.4 vs 44.5±21.1), respectively. Progressing from location 1 to 4, increased 3.11s -7.40 s at 2 L/min and 1.81s -4.18s at 5 L/min. Conclusion It was demonstrated that the elongated cannula insertion length resulted in lower embolic loads, particularly at a higher flow rate. The numerical results suggest that CPB management could combine active flow variation with improving cannula performance and provide a foundation for a future experimental and clinical investigation to reduce surgical cerebral air microemboli.

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Section: Methodsmentioning

confidence: 99%

“…1,30 In contrast, current numerical CFD cannula studies use a constant pump flow rate in the range of 4-5 L/min. 29,[31][32][33] Therefore, to determine the interaction of pump flow, two extreme differential non-pulsatile flows of 2 L/min and 5 L/min were arbitrarily chosen.…”

Section: Methodsmentioning

confidence: 99%

Effect of aortic cannulation depth on air emboli transport during cardiopulmonary bypass: A computational study

McDonald

Pauls

et al. 2022

Perfusion

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“…Several contributions described the CFD analysis to investigate the flow pattern induced by the aortic cannula during CPB [14][15][16][17] or in the presence of aortic pathologies [18,19]. Over recent years, the development and improvement of the aortic cannulation procedure has been the subject of enormous interest.…”

Section: Introductionmentioning

confidence: 99%

A Computational Fluid Dynamics Study to Compare Two Types of Arterial Cannulae for Cardiopulmonary Bypass

Gramigna,

Palumbo,

Rossi

et al. 2023

Fluids

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Thanks to recent technological and IT advances, there have been rapid developments in biomedical and health research applications of computational fluid dynamics. This is a methodology of computer-based simulation that uses numerical solutions of the governing equations to simulate real fluid flows. The aim of this study is to investigate, using a patient-specific computational fluid dynamics analysis, the hemodynamic behavior of two arterial cannulae, with two different geometries, used in clinical practice during cardiopulmonary bypass. A realistic 3D model of the aorta is extracted from a subject’s CT images using segmentation and reverse engineering techniques. The two cannulae, with similar geometry except for the distal end (straight or curved tip), are modeled and inserted at the specific position in the ascending aorta. The assumption of equal boundary conditions is adopted for the two simulations in order to analyze only the effects of a cannula’s geometry on hemodynamic behavior. Simulation results showed a greater percentage of the total output directed towards the supra-aortic vessels with the curved tip cannula (66% vs. 54%), demonstrating that the different cannula tips geometry produces specific advantages during cardiopulmonary bypass. Indeed, the straight one seems to generate a steadier flow pattern with good recirculation in the ascending aorta.

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“…Hemodynamic flow patterns inside the aneurysm and along parent arteries [12] provide important information concerning the growth, rupture risks and prediction of clinical outcome [2,[13][14][15], and hence have been studied intensively. Numerical simulations of the blood flow patterns inside the circulation system employing Computational Fluid Dynamics (CFD) has been widely used [16].…”

Section: Introductionmentioning

confidence: 99%

A Computational Hemodynamics Analysis on the Correlation Between Energy Loss and Clinical Outcomes for Flow Diverters Treatment of Intracranial Aneurysm

et al. 2018

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Rupture of intracranial aneurysms might lead to permanent disability or even death. One possible endovascular treatment is to deploy flow diverters (FDs), reducing flow into the sac and promoting thrombosis. Computational fluid dynamics simulations were used to assess the flow patterns and dynamics. The concept of energy loss, as a measure of work done necessary to overcome flow resistance, will be utilized to correlate with clinical outcome. If a surgical operation is successful, the flow is diverted to a shorter path and energy loss should be reduced. Conversely, persistent flow in the sac associated with treatment failure will display increased energy loss, as blood is then squeezed through the stent pores. Four illustrative clinical cases, involving both bifurcation and sidewall aneurysms, were selected. To reduce the numerical complexity, earlier works in the literature had employed a porous medium approximation for the FDs. Here the FD was simulated explicitly as a virtual (or computer generated) stent which would likely provide a more accurate description. Furthermore, quantitative comparisons between the approaches of virtual stent and porous medium with typical parameters were conducted by examining the effective flow influx into the aneurysm.

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Influence of Aortic Outflow Cannula Orientation on Epiaortic Flow Pattern During Pulsed Cardiopulmonary Bypass

Cited by 14 publications

References 29 publications

Effect of aortic cannulation depth on air emboli transport during cardiopulmonary bypass: A computational study

Effect of aortic cannulation depth on air emboli transport during cardiopulmonary bypass: A computational study

A Computational Fluid Dynamics Study to Compare Two Types of Arterial Cannulae for Cardiopulmonary Bypass

A Computational Hemodynamics Analysis on the Correlation Between Energy Loss and Clinical Outcomes for Flow Diverters Treatment of Intracranial Aneurysm

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