A New Coronary Artery Bypass Graft (CABG) Distal Anastomosis Design

This study is motivated by the requirement for a CABG distal anastomosis configuration which can bring about considerable improvements in the flow field and hemodynamic parameter (HP) distributions. A new CABG configuration is designed and compared to the conventional end-to-side (ETS) distal anastomosis by means of numerical simulation of pulsatile, Newtonian blood flow. There are two components in the design: a side-to-side (STS) anastomosis located distal to the coronary stenosis, after which the graft end is anastomosed further distal to the same coronary artery in an ETS fashion. Simulation results demonstrate that the new model has improved the flow fields and HP distributions as compared to the conventional ETS anastomosis, especially at the coronary artery bed and the heel region. Furthermore, this configuration provides a spare route for the blood flow to the coronary artery in case of re-stenosis in either of the anastomoses to avoid re-operation. Since this design involves one additional anastomosis and prolonged operation time, it is difficult to explicitly judge whether this configuration favors the CABG life span. It thus requires further concrete evidences from in-vivo experiments to demonstrate the outcome practically.