Hemodynamic effects of left cerebral artery stenosis during antegrade cerebral perfusion

Abstract

Objective: Antegrade cerebral perfusion (ACP) is the most common used method of perfusion in aortic arch surgery, but the complication of ACP investigation still have happened. In this paper, we present how to choose an appropriate method of ACP for the individual therapies for individual differences in cerebral blood vessels. Methods: We introduced the method of computational fluid dynamics (CFD) to quantitatively study the effects of the two types of perfusion. The MRA images were used to reconstruct an individual three-dimensional (3D) model of cerebral arteries. The pulsatile blood flow measured by Trans-Cranial Doppler ultrasonic-graph (TCD) was applied as boundary conditions for CFD simulations. Result: Hemodynamic parameters in the 3D cerebral vascular model were compared among the patients with the existence or absence Circle of Willis at the condition of the unilateral and bilateral antegrade selective cerebral perfusion. Pressure and mass flow are maintained both under unilateral perfusion and bilateral perfusion unless the wills ring is incomplete. Conclusion: For some patients with cerebral artery stenosis, the unilateral cerebral perfusion will cause brain injury.