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

Research output: Contribution to journalArticleAcademicpeer-review

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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 languageEnglish
Pages (from-to)916-926
Number of pages11
JournalJournal of Cardiovascular Translational Research
Issue number4
Early online date21 Mar 2023
Publication statusPublished - 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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