• 제목/요약/키워드: coronary circulation

검색결과 90건 처리시간 0.019초

협착된 관상동맥에 시술된 스텐트형상이 벽면 전단응력에 미치는 영향 (Effects of Stenting Shapes on the Wall Shear Stress in the Angulated Coronary Stenosis)

  • 조민태;서상호;유상신;권혁문
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2001년도 춘계학술대회논문집E
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    • pp.219-222
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    • 2001
  • The objective of the present study is to evaluate the effects of the stenting shapes on flow velocity and wall shear stress in angulated coronary stenosis by computer simulation. Coronary angiogram and Doppler ultrasound measurement in the patients with angulated coronary stenosis were obtained. Inlet wave velocity distribution obtained from in vivo intracoronary Doppler data was used for the numerical simulation. Spatial pattern of blood flow velocity and recirculation area were drawn through out the selected segment of coronary models. Wall shear stresses in the intracoronary stent models were calculated from three-dimensional computer simulation. A negative shear stress region, which is consistent with re-circulation area on flow pattern, was noted on the inner wall of post-stenotic area of pre-stenting model. The negative shear stress was disappeared after stenting. Shear stress in the post-stenting model was markedly reduced up to about two orders of magnitude compared to that of the pre-stenting model.

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Flow Visualization in Realistic Arterial Bypass Graft Model

  • Singh, Megha;Shin, Se-Hyun
    • International Journal of Vascular Biomedical Engineering
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    • 제3권1호
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    • pp.1-5
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    • 2005
  • Background: Coronary atherosclerosis artery disease is the leading cause of morbidity and mortality. Coronary artery bypass grafting (CABG) which utilizes the saphenous vein graft, has helped in alleviating the suffering of these patients. Newer techniques are being developed to improve upon the techniques. Still there is significant number of failures, leading to re-grafting or re-vascularization. Some studies have helped in identifying the high and low shear stress regions. Further studies based on their realistic models are required. Material, methods and results: we developed the realistic model of fully blocked right coronary with bypass graft placed at angle of $5^0$ with curvature similar to that of artery. Pulsatile flow of birefringent solution through this model by polarized light was visualized. The images of complete flow field in the model were recorded and analyzed. Regions of high flow disturbances which are prone to further changes are identified. Existence of recirculation in the blocked coronary may initiate new blood-tissue interactions deleterious to bypass graft. Conclusion: Our study shows that by selecting the procedure to place bypass graft at minimum angle with curvature similar to that of artery and smooth sutures may improve the life span of the graft. This study also identified that coronary blocked regions contributing by recirculation flow at the proximal and distal regions of bypass which may require further studies.

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Marfan 증후군에 동반된 우관상동맥 폐쇄증 - 1 례 보고 - (Right coronary artery atresia in Marfan's syndrome: A case report)

  • 이재원
    • Journal of Chest Surgery
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    • 제34권9호
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    • pp.720-723
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    • 2001
  • 우관상동맥 폐쇄증을 동반한 Marfan 증후군환자를 보고한다. 환자는 45세 여자로 약 1년 전에 Marfan 증후군으로 진단받고, 최근 흉통을 주소로 내원하였다. 환자는 손가락과 발가락이 긴 지주증과 돌출흉이 있고 몸통에 비해 사지가 긴 전형적인 외형을 갖고 있었다. 시력이 매우 약하고 수정체의 아탈구가 있었다. 심초음파상 대동맥판막 폐쇄부전증은 경도로 있었고, 좌심실의 중등도 확장과 심박출율의 중등도 저하가 있었다. 수술시에 우관상동맥의 폐쇄증을 발견하였다. 대동맥판막 폐쇄부전증과 대동맥 확장증에 대해서 SJM 27mm composite graft를 이용하여 좌관상동맥에는 Bentall 술식과 우관상동맥에는 PTFE 6mm를 이용하여 변형된 Piehler 식 방법으로 수술을 하였다. 원래의 우관상동맥구로 추정되는 부분부터 우관상동맥 원위부의 혈류가 있는 곳까지의 결손부위는 약 4cm 가량 되었다. 관상동맥 폐색증과 Marfan 증후군의 조합은 매우 드문 질환으로 양측 관상동맥의 혈류 재건을 위하여 각기 다른 술식으로 수술하였다.

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Hemodynamics of a Connecting conduit Between the Left Ventricle and the Left Decending Coronary Artery

  • Shim, Eun-Bo;Sah, Jong-Yub
    • International Journal of Vascular Biomedical Engineering
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    • 제1권2호
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    • pp.20-29
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    • 2003
  • A new treatment for coronary artery occlusive disease is being developed in which a shunt or conduit is placed directly connecting the left ventricle with the diseased artery at a point distal to the obstruction. To aid in assessing and optimizing its benefit, a computational model of the cardiovascular system was developed and used to explore various design conditions. Simulation results indicate that in complete LAD occlusion, flow can be returned to approximately 65% of normal if the conduit resistance is equal for forward and reverse flow, increasing to 80% in the limit in which backflow resistance is infinite. Increases in flow rate produced by asymmetric flow resistance are considerably enhanced in the case of a partial LAD obstruction since the primary effect of resistance asymmetry is to prevent leakage back into the ventricle("steal") during diastole. Increased arterial compliance has little effect on net flow with a symmetric shunt, but leads to considerable augmentation when the resistance is asymmetric. These results suggest that an LV-LAD conduit will be beneficial when stenosis resistance(Rst) > 27 PRU if resistance is symmetric.

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