Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach

Hanneke Crielaard; Marieke Hoogewerf; Bart P. van Putte; Frans N. van de Vosse; Georgios J. Vlachojannis; David Stecher; Marco Stijnen; Pieter A. Doevendans

doi:10.1007/s12265-023-10367-9

Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach

Hanneke Crielaard, Marieke Hoogewerf^*, Bart P. van Putte, Frans N. van de Vosse, Georgios J. Vlachojannis, David Stecher, Marco Stijnen, Pieter A. Doevendans

^*Corresponding author for this work

Cardiology

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Objectives: The ELANA® Heart Bypass creates a standardized sutureless anastomosis. Hereby, we investigate the influence of arteriotomy and graft size on coronary hemodynamics. Methods: A computational fluid dynamics (CFD) model was developed. Arteriotomy size (standard 1.43 mm²; varied 0.94 – 3.6 mm²) and graft diameter (standard 2.5 mm; varied 1.5 – 5.0 mm) were independent parameters. Outcome parameters were coronary pressure and flow, and fractional flow reserve (FFR). Results: The current size ELANA (arteriotomy 1.43 mm²) presented an estimated FFR 0.65 (39 mL/min). Enlarging arteriotomy increased FFR, coronary pressure, and flow. All reached a maximum once the arteriotomy (2.80 mm²) surpassed the coronary cross-sectional area (2.69 mm², i.e. 1.85 mm diameter), presenting an estimated FFR 0.75 (46 mL/min). Increasing graft diameter was positively related to FFR, coronary pressure, and flow. Conclusion: The ratio between the required minimal coronary diameter for application and the ELANA arteriotomy size effectuates a pressure drop that could be clinically relevant. Additional research and eventual lengthening of the anastomosis is advised. Graphical abstract: [Figure not available: see fulltext.]

Original language	English
Pages (from-to)	916-926
Number of pages	11
Journal	Journal of Cardiovascular Translational Research
Volume	16
Issue number	4
Early online date	21 Mar 2023
DOIs	https://doi.org/10.1007/s12265-023-10367-9
Publication status	Published - Aug 2023

Bibliographical note

Funding Information:
The PhD-fellowship of Marieke Hoogewerf is partially funded by AMT Medical Research B.V. Bart P. van Putte and Pieter A. Doevendans are consultant with AMT Medical B.V. David Stecher is registered co-inventor of patents regarding the ELANA technique, without financial benefits. All other authors declared no conflict of interest. The authors have performed a free and independent evaluation of this new technology and had full control of the design of the study, methods used, outcome parameters, analysis of data, and production of the written report.

Publisher Copyright:
© 2023, The Author(s).

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Crielaard, H., Hoogewerf, M., van Putte, B. P., van de Vosse, F. N., Vlachojannis, G. J., Stecher, D., Stijnen, M., & Doevendans, P. A. (2023). Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach. Journal of Cardiovascular Translational Research, 16(4), 916-926. Advance online publication. https://doi.org/10.1007/s12265-023-10367-9

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title = "Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach",

abstract = "Objectives: The ELANA{\textregistered} Heart Bypass creates a standardized sutureless anastomosis. Hereby, we investigate the influence of arteriotomy and graft size on coronary hemodynamics. Methods: A computational fluid dynamics (CFD) model was developed. Arteriotomy size (standard 1.43 mm2; varied 0.94 – 3.6 mm2) and graft diameter (standard 2.5 mm; varied 1.5 – 5.0 mm) were independent parameters. Outcome parameters were coronary pressure and flow, and fractional flow reserve (FFR). Results: The current size ELANA (arteriotomy 1.43 mm2) presented an estimated FFR 0.65 (39 mL/min). Enlarging arteriotomy increased FFR, coronary pressure, and flow. All reached a maximum once the arteriotomy (2.80 mm2) surpassed the coronary cross-sectional area (2.69 mm2, i.e. 1.85 mm diameter), presenting an estimated FFR 0.75 (46 mL/min). Increasing graft diameter was positively related to FFR, coronary pressure, and flow. Conclusion: The ratio between the required minimal coronary diameter for application and the ELANA arteriotomy size effectuates a pressure drop that could be clinically relevant. Additional research and eventual lengthening of the anastomosis is advised. Graphical abstract: [Figure not available: see fulltext.]",

author = "Hanneke Crielaard and Marieke Hoogewerf and {van Putte}, {Bart P.} and {van de Vosse}, {Frans N.} and Vlachojannis, {Georgios J.} and David Stecher and Marco Stijnen and Doevendans, {Pieter A.}",

note = "Funding Information: The PhD-fellowship of Marieke Hoogewerf is partially funded by AMT Medical Research B.V. Bart P. van Putte and Pieter A. Doevendans are consultant with AMT Medical B.V. David Stecher is registered co-inventor of patents regarding the ELANA technique, without financial benefits. All other authors declared no conflict of interest. The authors have performed a free and independent evaluation of this new technology and had full control of the design of the study, methods used, outcome parameters, analysis of data, and production of the written report. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = aug,

doi = "10.1007/s12265-023-10367-9",

language = "English",

volume = "16",

pages = "916--926",

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TY - JOUR

T1 - Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach

AU - Crielaard, Hanneke

AU - Hoogewerf, Marieke

AU - van Putte, Bart P.

AU - van de Vosse, Frans N.

AU - Vlachojannis, Georgios J.

AU - Stecher, David

AU - Stijnen, Marco

AU - Doevendans, Pieter A.

N1 - Funding Information: The PhD-fellowship of Marieke Hoogewerf is partially funded by AMT Medical Research B.V. Bart P. van Putte and Pieter A. Doevendans are consultant with AMT Medical B.V. David Stecher is registered co-inventor of patents regarding the ELANA technique, without financial benefits. All other authors declared no conflict of interest. The authors have performed a free and independent evaluation of this new technology and had full control of the design of the study, methods used, outcome parameters, analysis of data, and production of the written report. Publisher Copyright: © 2023, The Author(s).

PY - 2023/8

Y1 - 2023/8

N2 - Objectives: The ELANA® Heart Bypass creates a standardized sutureless anastomosis. Hereby, we investigate the influence of arteriotomy and graft size on coronary hemodynamics. Methods: A computational fluid dynamics (CFD) model was developed. Arteriotomy size (standard 1.43 mm2; varied 0.94 – 3.6 mm2) and graft diameter (standard 2.5 mm; varied 1.5 – 5.0 mm) were independent parameters. Outcome parameters were coronary pressure and flow, and fractional flow reserve (FFR). Results: The current size ELANA (arteriotomy 1.43 mm2) presented an estimated FFR 0.65 (39 mL/min). Enlarging arteriotomy increased FFR, coronary pressure, and flow. All reached a maximum once the arteriotomy (2.80 mm2) surpassed the coronary cross-sectional area (2.69 mm2, i.e. 1.85 mm diameter), presenting an estimated FFR 0.75 (46 mL/min). Increasing graft diameter was positively related to FFR, coronary pressure, and flow. Conclusion: The ratio between the required minimal coronary diameter for application and the ELANA arteriotomy size effectuates a pressure drop that could be clinically relevant. Additional research and eventual lengthening of the anastomosis is advised. Graphical abstract: [Figure not available: see fulltext.]

AB - Objectives: The ELANA® Heart Bypass creates a standardized sutureless anastomosis. Hereby, we investigate the influence of arteriotomy and graft size on coronary hemodynamics. Methods: A computational fluid dynamics (CFD) model was developed. Arteriotomy size (standard 1.43 mm2; varied 0.94 – 3.6 mm2) and graft diameter (standard 2.5 mm; varied 1.5 – 5.0 mm) were independent parameters. Outcome parameters were coronary pressure and flow, and fractional flow reserve (FFR). Results: The current size ELANA (arteriotomy 1.43 mm2) presented an estimated FFR 0.65 (39 mL/min). Enlarging arteriotomy increased FFR, coronary pressure, and flow. All reached a maximum once the arteriotomy (2.80 mm2) surpassed the coronary cross-sectional area (2.69 mm2, i.e. 1.85 mm diameter), presenting an estimated FFR 0.75 (46 mL/min). Increasing graft diameter was positively related to FFR, coronary pressure, and flow. Conclusion: The ratio between the required minimal coronary diameter for application and the ELANA arteriotomy size effectuates a pressure drop that could be clinically relevant. Additional research and eventual lengthening of the anastomosis is advised. Graphical abstract: [Figure not available: see fulltext.]

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U2 - 10.1007/s12265-023-10367-9

DO - 10.1007/s12265-023-10367-9

M3 - Article

AN - SCOPUS:85150493129

SN - 1937-5387

VL - 16

SP - 916

EP - 926

JO - Journal of Cardiovascular Translational Research

JF - Journal of Cardiovascular Translational Research

IS - 4

ER -

Evaluating the Arteriotomy Size of a New Sutureless Coronary Anastomosis Using a Finite Volume Approach

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