Computational fluid dynamics simulation of the right subclavian artery cannulation

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 154; no. 2; pp. 480 - 487
• Main Authors: Numata, Satoshi, MD, PhD, Itatani, Keiichi, MD, PhD, Kawajiri, Hidetake, MD, PhD, Yamazaki, Sachiko, MD, PhD, Kanda, Keiichi, MD, PhD, Yaku, Hitoshi, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Aged; Aged, 80 and over; Aorta - physiology; Aorta, Thoracic - physiology; Aortic Aneurysm - physiopathology; Brachiocephalic Trunk - physiology; cardiopulonary bypass; Cardiothoracic Surgery; Catheterization, Central Venous; Computer Simulation; fluid dynamics; Hemodynamics; Humans; Male; subclavian artery; Subclavian Artery - physiology; CFD; magnetic resonance imaging; computational fluid dynamics; MRI; subclavian artery; rSCA; fluid dynamics; right subclavian artery; 3D; AscAo; cardiopulonary bypass; 3-dimensional; ascending aorta
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2017.02.073

Abstract Objective The purpose of this study was to evaluate the efficacy of right subclavian artery cannulation using computational fluid dynamics. Methods Patient-specific models of the aortic arch were made with 4 patterns (1: normal aorta, 2: ascending aorta aneurysm, 3: distal arch aneurysm, 4: bovine arch) based on the computed tomography images. Right subclavian artery and ascending aorta cannulation models were created to simulate the physiologic pulsatile flow. Perfusion flow through the arterial cannula was set to 2.50 L/min (50% flow), 3.75 L/min (75% flow), and 5.0 L/min (100%), respectively, and a 3-dimensional movie was made of 1 cardiac cycle to evaluate the blood flow. Results In both 50% and 75% flow simulation with right subclavian artery cannulation, the blood streamline from the right subclavian artery produced retrograde flow of the brachiocephalic artery and antegrade flow of the right common carotid artery throughout the cardiac cycle in all cases. Right subclavian artery flow deflected ascending aorta flow to the descending aorta. Left-side supra-aortic branches were perfused by blood flow from both the right subclavian artery cannula and the aortic valve. The ascending aortic cannulation model showed that blood flow from the aortic valve reached all 3 supra-aortic vessels in systole. Conclusions Right subclavian artery cannulation was cerebroprotective, especially on the right side.