• Title/Summary/Keyword: stenosed artery

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Complications amd Mortality After Coronary Artery Bypass Graft Surgery; Collective Review of 61 Cases (관상동맥우회수술후 합병증과 사망율에 대한 임상적 고찰;61례 보고)

  • 조건현
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.526-531
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    • 1993
  • Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.

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Asymmetric flows of non-Newtonian fluids in symmetric stenosed artery

  • Hun Jung;Park, Jong-Wook;Park, Chan-Guk
    • Korea-Australia Rheology Journal
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    • v.16 no.2
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    • pp.101-108
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    • 2004
  • The hemodynamics behavior of the blood flow is influenced by the presence of the arterial stenosis. If the stenosis is present in an artery, normal blood flow is disturbed. In the present study, the characteristics of pulsatile flow in the blood vessel with stenosis are investigated by the finite volume method. For the validation of numerical model, the computation results are compared with the experimental ones of Ojha et al. in the case of 45% stenosis with a trapezoidal profile. Comparisons between the measured and the computed velocity profiles are favorable to our solutions. Finally, the effects of stenosis severity and wall shear stress are discussed in the present computational analysis. It can be seen, where the non-dimensional peak velocity is displayed for all the stenosis models at a given severity of stenosis, that it is exponentially increased. Although the stenosis and the boundary conditions are all symmetric, the asymmetric flow can be detected in the more than 57% stenosis. The instability by a three-dimensional symmetry-breaking leads to the asymmetric separation and the intense swirling motion downstream of the stenosis.

Influences of Geometric Configurations of Bypass Grafts on Hemodynamics in End-to-Side Anastomosis

  • Choi, Jae-Sung;Hong, Sung-Chul;Kwon, Hyuck-Moon;Suh, Sang-Ho;Lee, Jeong-Sang
    • Journal of Chest Surgery
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    • v.44 no.2
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    • pp.89-98
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    • 2011
  • Background: Although considerable efforts have been made to improve the graft patency in coronary artery bypass surgery, the role of biomechanical factors remains underrecognized. The aim of this study is to investigate the influences of geometric configurations of the bypass graft on hemodynamic characteristics in relation to anastomosis. Materials and Methods: The Numerical analysis focuses on understanding the flow patterns for different values of inlet and distal diameters and graft angles. The Blood flow field is treated as a two-dimensional incompressible laminar flow. A finite volume method is adopted for discretization of the governing equations. The Carreau model is employed as a constitutive equation for blood. In an attempt to obtain the optimal aorto-coronary bypass conditions, the blood flow characteristics are analyzed using in vitro models of the end-to-side anastomotic angles of $45^{\circ}$, $60^{\circ}$ and $90^{\circ}$. To find the optimal graft configurations, the mass flow rates at the outlets of the four models are compared quantitatively. Results: This study finds that Model 3, whose bypass diameter is the same as the inlet diameter of the stenosed coronary artery, delivers the largest amount of blood and the least pressure drop along the arteries. Conclusion: Biomechanical factors are speculated to contribute to the graft patency in coronary artery bypass grafting.

DEVELOPMIN OF A MODIFIED $k-{\varepsilon}$ TURBULENCE MODEL FOR VISCO-ELASTIC FLUID AND ITS APPLICATION TO HEMODYNAMICS (점탄성 유체의 난류 해석을 위한 수정된 $k-{\varepsilon}$ 난류모델 개발 및 혈류역학에의 적용)

  • Ro, K.C.;Ryou, H.S.
    • 한국전산유체공학회:학술대회논문집
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    • 2010.05a
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    • pp.214-220
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    • 2010
  • This article described that a high Reynolds number version of a turbulence model was modified by using drag reduction to analyze the turbulent flows of non-Newtonian fluid with visco-elastic viscosity and it was applied hemodynamics which was representative of visco-elastic fluid. The turbulence characteristics of visco-elastic fluid was expanded viscous sublayer region and buffer layer region by drag reduction phenomenon and also Newtonian turbulence models does not predict because viscosity was related with shear rate of fluid flow. Hence numerical simulation using a modified turbulence model was conducted under the same conditions that were applied to obtain the experiment results and previous turbulence models and then the numerical investigation of turbulent blood flow in the stenosed artery bifurcation under periodic acceleration of the human body.

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Study of Blood Characteristics in Stenosed Artery under Human Body Rotation by Using FSI Method (FSI 기법을 적용한 인체 회전 시 협착 혈관에서의 혈류 특성)

  • Cho, Seong Wook;Kim, Seungwook;Ro, Kyoung Chul;Ryou, Hong Sun
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.5
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    • pp.449-457
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    • 2013
  • In this study, we performed a numerical analysis to investigate the effect of rotation on the blood flow and arterial wall behavior by using the FSI (fluid-structure interaction) technique. The geometry of the artery included 50% stenosis at the center. To simulate the rotational effect, 2-6 rps of axial velocity was applied to the arterial model. A spiral wave and asymmetric flow occurred due to the stenosis and axial rotation both in the rigid body model and in the FSI model. However, the arterial wall motion caused periodic and transient blood flow changes in the FSI model. The FRZ (fluid recirculation zone) decreased in the FSI model, which is a known predictor for the formation and vulnerability of plaque. Therefore, it is observed that arterial wall motion also influences the generation of the FRZ.

Antithrombotic Therapy for Ischemic Stroke (허혈성 뇌졸중에서의 항혈전 치료)

  • Hah, Jung-Sang;Lee, Jun
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.1-12
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    • 2003
  • Ischemic stroke is among the principal causes of death and disability in the elderly. Although control of blood pressure, decreased cigarette smoking, and modified dietary habits are among important reasons for stroke decline, the use of antithrombotic therapy, rigorously prescribed. Several antiplatelet agents are approved to reduce the risk of recurrent stroke. Aspirin is the best-studied and most widely used antiplatelet agent for stroke prevention; it provides approximately 15% to 25% relatively risk reduction for secondary prevention of stroke or the major vascular death. Combining 2 antiplatelet agents with different mechanism of action was demonstrated to provide a substantial increase in efficacy in several studies. Anticoagulation should be considered first with potential cardiac sources of embolism. Heparin reduces development of erythrocyte-fibrin thrombi that form in regions of vascular stasis especially within the heart, in severely stenosed arteries sometimes engrafted on white thrombi, in acute arterial occlusion. Heparin should not be indiscriminately given to all acute brain ischemia patients, but may contribute to treatment of large artery occlusion and severe stenosis, cardiogenic embolism with a high acute recurrence risk, and dural sinus and cerebral venous thromobosis.

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DEVELOPMENT OF A MODIFIED $k-{\varepsilon}$ TURBULENCE MODEL FOR VISCO-ELASTIC FLUID AND ITS APPLICATION TO HEMODYNAMICS (점탄성 유체의 난류 해석을 위한 수정된 $k-{\varepsilon}$ 난류모델 개발 및 혈류역학에의 적용)

  • Ro, K.C.;Ryou, H.S.
    • Journal of computational fluids engineering
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    • v.15 no.4
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    • pp.1-8
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    • 2010
  • This article describes the numerical investigation of turbulent blood flow in the stenosed artery bifurcation under periodic acceleration of the human body. Numerical analyses for turbulent blood flow were performed with different magnitude of periodic accelerations using a modified turbulence model which was considering drag reduction of non-Newtonian fluid. The blood was considered to be a non-Newtonian fluid which was based on the power-law viscosity. In order to validate the modified $k-{\varepsilon}$ model, numerical simulations were compared with the standard $k-{\varepsilon}$ model and the Malin's low Reynolds number turbulence model for power-law fluid. As results, the modified $k-{\varepsilon}$ model represents intermediate characteristics between laminar and standard $k-{\varepsilon}$ model, and the modified $k-{\varepsilon}$ model showed good agreements with Malin's verified power law model. Moreover, the computing time and computer resource of the modified $k-{\varepsilon}$ model were reduced about one third than low Reynolds number model including Malin's model.

Dynamic response of heat and mass transfer in blood flow through stenosed bifurcated arteries

  • Charkravarty S.;Sen S.
    • Korea-Australia Rheology Journal
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    • v.17 no.2
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    • pp.47-62
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    • 2005
  • The present study deals with a mathematical model describing the dynamic response of heat and mass transfer in blood flow through bifurcated arteries under stenotic condition. The geometry of the bifurcated arterial segment possessing constrictions in both the parent and the daughter arterial lumen frequently appearing in the diseased arteries causing malfunction of the cardiovascular system, is formulated mathematically with the introduction of the suitable curvatures at the lateral junction and the flow divider. The blood flowing through the artery is treated to be Newtonian. The nonlinear unsteady flow phenomena is governed by the Navier-Stokes equations while those of heat and mass transfer are controlled by the heat conduction and the convection-diffusion equations respectively. All these equations together with the appropriate boundary conditions describing the present biomechanical problem following the radial coordinate transformation are solved numerically by adopting finite difference technique. The respective profiles of the flow field, the temperature and the concentration and their distributions as well are obtained. The influences of the stenosis, the arterial wall motion and the unsteady behaviour of the system in terms of the heat and mass transfer on the blood stream in the entire arterial segment are high­lighted through several plots presented at the end of the paper in order to illustrate the applicability of the present model under study.

The Clinical Experiences of Patch Angioplasty in Isolated Critical Left Main Coronary Artery Stenosis (첨포를 이용한 좌주관상동맥 협착증의 치료)

  • 윤치순;유경종;이교준;김대준;강면식
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.674-678
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    • 1998
  • The conventional surgical treatment of isolated critical stenosis of the left main coronary artery restores a less physiologic perfusion of the myocardium, leads to occlusion of the left coronary ostium, and consumes an appreciable length of bypass material. From June 1994 to February 1996, eleven patients, three male and eight female, underwent patch angioplasty and additional bypass graft to left anterior descending artery (10 internal mammary artery, 1 saphenous vein) in isolated critical left main coronary artery stenosis. Their ages ranged from 34 to 62 years, mean 44 years. All had 60% to 90% stenosis of the left main coronary artery and Class III angina. The angiogram showed nine osteal lesion and three main stem stenosis. The operation was performed with conventional cardiopulmonary bypass and cold blood cardioplegia. We approached anteriorly and used bovine pericardium as onlay patch in all patients. There were one leg wound dehiscence, but no operative deaths and infarctions. All patients are free of symptoms after a mean follow-up of 15.5 months. Angiographic restudy at an average 14.4 months was obtained in five patients and showed widely patent left main coronary artery with excellent runoff. But additional graft to left anterior descending coronary artery were stenosed in two patients and showed diminutive flow in others. Our preliminary results suggest that angioplasty of the left main coronary artery can be carried out with low operative risks. But additional bypass graft to left anterior descending coronary artery may be unnecessary. The technique appears to be a promising alternative to conventional coronary artery bypass grafting in isolated left main coronary artery stenosis.

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Modeling of Hemodynamics in Stenosed Artery (협착 동맥혈관의 혈류유동 모델링)

  • Kim, Seong-Jong;Park, Young-Ran;Kim, Shagn-Jin;Kang, Hyung-Sub;Kim, Jin-Shang;Oh, Sung-Hoon;Kang, Sung-Jun;Kim, Gi-Beum
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.5
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    • pp.2285-2290
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    • 2012
  • This study is about atherosclerosis which occupies the highest rate in many diseases people have and we have studied about atherosclerosis for abdominal aorta. Atherosclerosis is the phenomenon which blood vessel gets narrower, harder and thicker due to the stenosis of colesterol in blood vessel. If it becomes worse, arteries will be hard and blood can't flow smoothly, and even it can reach to death. In this study, the geometric models of the considered stenotic blood flow are two different types of constriction of cross-sectional area of blood vessel; 20 and 45% of constriction in each elastic wall and rigid wall. We have modeled by using finite element method to observe the changes of velocity and pressure. In case of the diameter of blood vessel decreased 45% in elastic wall model, the values of velocity and pressure were higher than the case of 20% and in case of the diameter of blood vessel decreased 45% in rigid wall model, the values of velocity and pressure were higher than the case of 20%. In cases of elastic wall models of the diameters of blood vessels decreased each of 20% and 45%, recirculation zones appeared. This results show understanding of hemodynamic properties depending on stenosed blood vessels.