MOX, Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, Milano 20133, Italy.
Radiology Unit, Ospedale L. Sacco, Via G.B. Grassi 74, Milano 20157, Italy.
Med Eng Phys. 2017 Sep;47:117-127. doi: 10.1016/j.medengphy.2017.05.008. Epub 2017 Jul 19.
Coronary artery disease is one of the leading causes of death worldwide. The stenotic coronary vessels are generally treated with coronary artery bypass grafts (CABGs), which can be either arterial (internal mammary artery, radial artery) or venous (saphenous vein). However, the different mechanical properties of the graft can influence the outcome of the procedure in terms of risk of restenosis and subsequent graft failure. In this paper, we perform a computational fluid-structure interaction (FSI) analysis of patient-specific multiple CABGs (Y-grafts) with the aim of better understanding the influence of the choice of bypass (arterial vs venous) on the risk of graft failure. Our results show that the use of a venous bypass results in a more disturbed flow field at the anastomosis and in higher stresses in the vessel wall with respect to the arterial one. This could explain the better long-term patency of the arterial bypasses experienced in the clinical practice.
冠状动脉疾病是全球范围内主要的死亡原因之一。狭窄的冠状动脉通常采用冠状动脉旁路移植术（CABG）进行治疗，包括动脉（内乳动脉、桡动脉）或静脉（大隐静脉）。然而，移植物的不同力学特性可能会影响手术的结果，包括再狭窄和随后的移植物失败的风险。在本文中，我们对特定患者的多个 CABG（Y 型移植物）进行了计算流体力学-结构相互作用（FSI）分析，目的是更好地理解旁路选择（动脉与静脉）对移植物失败风险的影响。我们的结果表明，与动脉旁路相比，静脉旁路在吻合处会导致更紊乱的流场，并在血管壁上产生更高的应力。这可以解释为什么在临床实践中，动脉旁路的长期通畅率更好。
