Abstract
Creation of emboli in the aortic root and changes in flow distribution between supra-aortic arteries and descending aorta can lead to stroke and perfusion related tissue damage during cardiopulmonary bypass. A thorough understanding of how the angle of cannulation affects the overall success of cardiopulmonary bypass during cannulation of the ascending aorta is needed. Previous simulation research has observed the effect of outflow cannula position by changing the location of the cannulation site to the subclavian artery and other vessels, as well as positions for innovative cannula designs. The purpose of this study is to evaluate the success of the procedure while using a straight cannula, modulating the angle of cannulation below horizontal in the frontal plane. A simplified geometry of the aorta was used. The success of the procedure was quantified by observing wall shear stress, normal stress, intra-fluid shear stress, and flow distribution. A numerical study was performed to solve the Reynolds Averaged Naiver Stokes governing equations, which were used in conjunction with a constant density fluid to simulate blood, and a realizable two-layer k-e turbulence model.
Highlights
Cardiopulmonary bypass is a routine medical procedure that allows the heart to be stopped while still delivering oxygenated blood to the body tissues
Major factors that influence the success of the Cardiopulmonary bypass (CPB) procedure are shear stress and pressure on the walls of the aorta that lead to mobilization of an atherosclerotic embolism, stagnant blood flow that could lead to thrombotic embolism, flow distribution that could lead to poor end organ perfusion, and high intra-fluid shear stress that leads to hemolysis
Successful cardiopulmonary bypass produces flow distributions that closely resemble that of normal cardiac function
Summary
Cardiopulmonary bypass is a routine medical procedure that allows the heart to be stopped while still delivering oxygenated blood to the body tissues. If the ascending aorta is being cannulated, the angle of which the cannula is introduced to the major vessel can mean the difference between a successful procedure and a procedure that results in a range of post-operative disorders, related to the nature of the perfusion. Cardiopulmonary bypass (CPB) has been used for decades with success for most patients undergoing the procedure. Major factors that influence the success of the CPB procedure are shear stress and pressure on the walls of the aorta that lead to mobilization of an atherosclerotic embolism, stagnant blood flow that could lead to thrombotic embolism, flow distribution that could lead to poor end organ perfusion, and high intra-fluid shear stress that leads to hemolysis
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