Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach

Hanneke Crielaard, Marieke Hoogewerf (Corresponding author), Bart P. van Putte, Frans N. van de Vosse, Georgios J. Vlachojannis, David Stecher, Marco Stijnen, Pieter A. Doevendans

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Objectives: The ELANA® Heart Bypass creates a standardized sutureless anastomosis. Hereby, we investigate the influence of arteriotomy and graft size on coronary hemodynamics. Methods: A computational fluid dynamics (CFD) model was developed. Arteriotomy size (standard 1.43 mm2; varied 0.94 – 3.6 mm2) and graft diameter (standard 2.5 mm; varied 1.5 – 5.0 mm) were independent parameters. Outcome parameters were coronary pressure and flow, and fractional flow reserve (FFR). Results: The current size ELANA (arteriotomy 1.43 mm2) presented an estimated FFR 0.65 (39 mL/min). Enlarging arteriotomy increased FFR, coronary pressure, and flow. All reached a maximum once the arteriotomy (2.80 mm2) surpassed the coronary cross-sectional area (2.69 mm2, i.e. 1.85 mm diameter), presenting an estimated FFR 0.75 (46 mL/min). Increasing graft diameter was positively related to FFR, coronary pressure, and flow. Conclusion: The ratio between the required minimal coronary diameter for application and the ELANA arteriotomy size effectuates a pressure drop that could be clinically relevant. Additional research and eventual lengthening of the anastomosis is advised. Graphical abstract: [Figure not available: see fulltext.].

Originele taal-2Engels
Pagina's (van-tot)916-926
Aantal pagina's11
TijdschriftJournal of Cardiovascular Translational Research
Nummer van het tijdschrift4
StatusGepubliceerd - aug. 2023


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