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Effect of Patency of the Proximal Outflow Segment and Angle of Anastomosis

Howard M. Crawshaw, FRCS; William C. Quist; Eugene Serrallach, PhD; C. Robert Valeri, MD; Frank W. LoGerfo, MD

Arch Surg. 1980;115(11):1280-1284.

Abstract
• We investigated the flow disturbance that occurs at the distal end-to-side anastomosis. Clear plastic model end-to-side anastomoses were constructed with inlet angles of 15° and 45°. Flow patterns were visualized with steady and pulsatile flow using a dye-injection technique. Multiple lateral pressure measurements were made in the region of the anastomosis. A laser Doppler anemometer was used to measure near-wall velocity. Flow disturbance was minimal when the inlet angle was low and the proximal outflow segment occluded. Patency of the proximal outflow segment or a high inlet angle may result in areas of boundary-layer separation, with corresponding adverse pressure gradients at the anastomosis. These separation regions are characterized by low near-wall velocity, which may contribute to anastomotic hyperplasia.

(Arch Surg 115:1280-1284, 1980)

Author Affiliations
From the Vascular Dynamics Laboratory, Division of Surgery, Boston University Medical Center, and the Naval Blood Research Laboratory, Boston.

Footnotes
Accepted for publication Aug 5, 1980.

Read before the 28th scientific meeting of the International Cardiovascular Society, Chicago, June 27, 1980.

Reprint requests to University Hospital, 75 E Newton St, Boston, MA 02118 (Dr LoGerfo).

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