Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Comparison of Hemodynamic Energy between Expanded Polytetrafluoroethylene and Dacron Artificial Vessels

  • Lim, Jaekwan (Biomedical Research Center, Korea Testing Laboratory) ;
  • Won, Jong Yun (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Ahn, Chi Bum (Biomedical Engineering Research Center, Asan Medical Center) ;
  • Kim, Jieon (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Kim, Hee Jung (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine) ;
  • Jung, Jae Seung (Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine)
  • Received : 2020.10.08
  • Accepted : 2020.11.23
  • Published : 2021.04.05
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Abstract

Background: Artificial grafts such as polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) are used for various cardiovascular surgical procedures. The compliance properties of prosthetic grafts could affect hemodynamic energy, which can be measured using the energy-equivalent pressure (EEP) and surplus hemodynamic energy (SHE). We investigated changes in the hemodynamic energy of prosthetic grafts. Methods: In a simulation test, the changes in EEP for these grafts were estimated using COMSOL MULTIPHYSICS. The Young modulus, Poisson ratio, and density were used to analyze the grafts' material properties, and pre- and post-graft EEP values were obtained by computing the product of the pressure and velocity. In an in vivo study, Dacron and ePTFE grafts were anastomosed in an end-to-side fashion on the descending thoracic aorta of swine. The pulsatile pump flow was fixed at 2 L/min. Real-time flow and pressure were measured at the distal part of each graft, while clamping the other graft and the descending thoracic aorta. EEP and SHE were calculated and compared. Results: In the simulation test, the mean arterial pressure decreased by 39% for all simulations. EEP decreased by 42% for both grafts, and by around 55% for the native blood vessels after grafting. The in vivo test showed no significant difference between both grafts in terms of EEP and SHE. Conclusion: The post-graft hemodynamic energy was not different between the Dacron and ePTFE grafts. Artificial grafts are less compliant than native blood vessels; however, they can deliver pulsatile blood flow and hemodynamic energy without any significant energy loss.

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References

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