Numerical analysis of coronary artery bypass grafts: An over view

Abstract

Arterial bypass grafts tend to fail after some years due to the development of intimal thickening (restenosis). Non-uniform hemodynamics following a bypass operation contributes to restenosis and bypass failure can occur due to the focal development of anastomotic intimal hyperplasia. Additionally, surgical injury aggravated by compliance mismatch between the graft and artery has been suggested as an initiating factor for progress of wall thickening along the suture line Vascular grafts that are small in diameter tend to occlude rapidly. Computational fluid dynamics (CFD) methods have been effectively used to simulate the physical and geometrical parameters characterizing the hemodynamics of various arteries and bypass configurations. The effects of such changes on the pressure and flow characteristics as well as the wall shear stress during a cardiac cycle can be simulated. Recently, utilization of fluid and structure interactions have been used to determine fluid flow parameters and structure forces including stress and strains relationships under steady and transient conditions. In parallel to this, experimental diagnostics techniques such as Laser Doppler Anemometry, Particle Image Velocimetry, Doppler Guide wire and Magnetic Resonance Imaging have been used to provide essential information and to validate the numerical results. Moreover, clinical imaging techniques such as magnetic resonance or computed tomography have assisted considerably in gaining a detailed patient-specific picture of the blood flow and structure dynamics. This paper gives a review of recent numerical investigations of various configurations of coronary artery bypass grafts (CABG). In addition, the paper ends with a summary of the findings and the future directions.