Morphological analysis of central composite graft anastomosis in CABG

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K16555
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55030:Cardiovascular surgery-related
• Research Institution: Chiba University
• Principal Investigator: Yakita Yasunori 千葉大学, 医学部附属病院, 特任研究員 (40790671)
• Project Period (FY): 2022-04-01 – 2024-03-31
• Keywords: 数値流体力学 / 冠動脈外科 / 心臓血管外科

Outline of Final Research Achievements

This study aimed to identify the optimal central anastomotic configuration for achieving the longest patency when using two or more free grafts by analyzing the blood flow distribution for each anastomotic morphology using computational fluid dynamics. An ideal coronary artery anastomosis model was constructed, and blood flow analyses were conducted on various models by altering graft anastomotic positions, angles, and vessel diameters to investigate hemodynamic variations. The results of the flow analysis suggested that in the case of PiggyBack anastomosis, the second graft, when anastomosed near the first central anastomosis and in the opposite direction, could potentially yield greater flow rates and longer-term patency.

Free Research Field

心臓血管外科学

Academic Significance and Societal Importance of the Research Achievements

本邦では諸外国に比べてCABGを行う際に人工心肺を使用しないoff-pump CABG(OPCAB)が多く行われる傾向にある。OPCABの利点として出血・輸血量の減少、術後の肺・腎・ 脳機能障害の減少、全身性炎症反応の軽減、人工呼吸器からの早期離脱、集中治療室の早期退室、早期退院、死亡率の低下などが挙げられる。心拍動を残したまま上行大動脈にグラフトを吻合するために補助デバイスが使用されるが、free graftの中枢吻合が２ヶ所以上の場合は複数のデバイスを使う必要がある。この様な状況から、中枢吻合を１ヶ所で済ますことができるcomposite graftの有用性を示す必要がある。