Comparison of Hemodynamic Energy between Expanded Polytetrafluoroethylene and Dacron Artificial Vessels

다국어 초록 (Multilingual Abstract)

Background: Artificial grafts such as polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) are used for various cardiovascular surgical procedures. The compliance properties of prosthetic grafts could affect hemodynamic energy, which can be measured using the energy-equivalent pressure (EEP) and surplus hemodynamic energy (SHE). We investigated changes in the hemodynamic energy of prosthetic grafts. Methods: In a simulation test, the changes in EEP for these grafts were estimated using COMSOL MULTIPHYSICS. The Young modulus, Poisson ratio, and density were used to an- alyze the grafts’ material properties, and pre- and post-graft EEP values were obtained by computing the product of the pressure and velocity. In an in vivo study, Dacron and ePTFE grafts were anastomosed in an end-to-side fashion on the descending thoracic aorta of swine. The pulsatile pump flow was fixed at 2 L/min. Real-time flow and pressure were measured at the distal part of each graft, while clamping the other graft and the descend- ing thoracic aorta. EEP and SHE were calculated and compared.
Results: In the simulation test, the mean arterial pressure decreased by 39% for all sim- ulations. EEP decreased by 42% for both grafts, and by around 55% for the native blood vessels after grafting. The in vivo test showed no significant difference between both grafts in terms of EEP and SHE.
Conclusion: The post-graft hemodynamic energy was not different between the Dacron and ePTFE grafts. Artificial grafts are less compliant than native blood vessels; however, they can deliver pulsatile blood flow and hemodynamic energy without any significant energy loss.

참고문헌 (Reference)

1 Travis AR, "Vascular pulsatility in patients with a pulsatile-or continuous-flow ventricular assist device" 133 : 517-524, 2007

2 Son HS, "The effects of pulsatile versus non-pulsatile extracorporeal circulation on the pattern of coronary artery blood flow during cardiac arrest" 28 : 609-616, 2005

3 Kim HK, "The effects of pulsatile flow upon renal tissue perfusion during cardiopulmonary bypass: a comparative study of pulsatile and nonpulsatile flow" 51 : 30-36, 2005

4 Lim CH, "The effects of dopamine, ephinephrine, and esmolol on the hemodynamic energy in terms of the energy equivalent pressure" 53 : 791-794, 2007

5 Jung JS, "Pulsatile versus nonpulsatile flow to maintain the equivalent coronary blood flow in the fibrillating heart" 53 : 785-790, 2007

6 Wu R, "Percutaneous transluminal angioplasty versus primary stenting in infrapopliteal arterial disease: a meta-analysis of randomized trials" 59 : 1711-1720, 2014

7 Undar A, "Pediatric physiologic pulsatile pump enhances cerebral and renal blood flow during and after cardiopulmonary bypass" 26 : 919-923, 2002

8 Konig G, "Mechanical properties of completely autologous human tissue engineered blood vessels compared to human saphenous vein and mammary artery" 30 : 1542-1550, 2009

9 Walden R, "Matched elastic properties and successful arterial grafting" 115 : 1166-1169, 1980

10 Sezai A, "Major organ function under mechanical support: comparative studies of pulsatile and nonpulsatile circulation" 23 : 280-285, 1999

11 Soldani G, "Long term performance of smalldiameter vascular grafts made of a poly(ether)urethane-polydimethylsiloxane semi-interpenetrating polymeric network" 31 : 2592-2605, 2010

12 Canaud L, "Infrainguinal angioplasty with drug-eluting stents and balloons" 59 : 1721-1736, 2014

13 Wright G, "Hemodynamic analysis could resolve the pulsatile blood flow controversy" 58 : 1199-1204, 1994

14 Xie X, "Fluoropassivation and gelatin sealing of polyester arterial prostheses to skip preclotting and constrain the chronic inflammatory response" 93 : 497-509, 2010

15 Shepard RB, "Energy equivalent pressure" 93 : 730-740, 1966

16 Jeong GS, "Development of a closed air loop electropneumatic actuator for driving a pneumatic blood pump" 33 : 657-662, 2009

17 Tai NR, "Compliance properties of conduits used in vascular reconstruction" 87 : 1516-1524, 2000

18 Ji B, "Comparison of perfusion modes on microcirculation during acute and chronic cardiac support: is there a difference?" 22 : 115-119, 2007

19 Lim CH, "Comparison of coronary artery blood flow and hemodynamic energy in a pulsatile pump versus a combined nonpulsatile pump and an intra-aortic balloon pump" 52 : 595-597, 2006

20 Yuan L, "Clinical results of percutaneous transluminal angioplasty for thromboangiitis obliterans in arteries above the knee" 235 : 110-115, 2014

21 Chlupac J, "Blood vessel replacement : 50years of development and tissue engineering paradigms in vascular surgery" 58 (58): S119-S139, 2009