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A Novel Inflatable Belt-Type Clamp in Open Heart Surgery

Published online by Cambridge University Press:  31 March 2011

C.-Y. Wen*
Affiliation:
Department of Aeronautics and Astronautics, National Cheng Kung University, Tainan, Taiwan 70101, R.O.C.
C.-Y. Lee
Affiliation:
Department of Mechanical Engineering, National Taipei University of Technology, Taipei, Taiwan 10608, R.O.C.
H.-Y. Yu
Affiliation:
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan 10002, R.O.C.
H.-T. Chang
Affiliation:
Department of Aeronautics and Astronautics, National Cheng Kung University, Tainan, Taiwan 70101, R.O.C.
*
* Professor, corresponding author
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Abstract

In this study, a novel inflatable belt-type clamp is introduced and its performance is verified. Finite element simulations are performed to compare the performance of three different aorta clamping systems. In every case, the aorta is modeled as a simple hollow cylinder made of linearly elastic material. For a traditional surgical clamp in which the jaws remain inclined to one another as they close around the aorta, the maximum normal stress within the aorta wall is found to be 806kPa. It is shown that the numerical results are in good qualitative agreement with the experimental results obtained using a pressure sensitive film. The simulation results for a modified clamp in which the jaws remain parallel during the clamping operation show that the maximum normal stress is reduced to 222kPa. However, two regions of maximum stress are induced within the aorta wall. Finally, the numerical results for a novel inflatable belt-type clamp show that the maximum normal stress is equal to approximately 221kPa. In contrast to the modified clamp, the stress is uniformly distributed around the perimeter of the aorta, and thus the risk of aortic dissection is significantly reduced.

Type
Articles
Copyright
Copyright © The Society of Theoretical and Applied Mechanics, R.O.C. 2011

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References

REFERENCES

1.Still, R. J., Hilgenberg, A. D., Akins, C. W., Daggett, W. M. and Buckley, M. J., “Intraoperative Aortic Dissection,” The Annals of Thoracic Surgery, 53, pp. 374379 (1992).CrossRefGoogle ScholarPubMed
2.Ruchat, P., Hurni, M., Stumpe, F., Fischer, A. P. and Segesser, von L. K., “Acute Ascending Aortic Dissection Complicating Open Heart Surgery: Cerebral Perfusion Defines the Outcome,” European Journal of Cardiothoracic Surgery, 14, pp. 449452 (1998).CrossRefGoogle ScholarPubMed
3.Aoyagi, S., Tayama, E., Nishimi, M., Chihara, S., Onizuka, S. and Fukunaga, S., “Aortic Dissections Complicating Open Cardiac Surgery: Report of Three Cases,” Surgery Today, 11, pp. 10221025 (2000).CrossRefGoogle Scholar
4.Cottrell, D. J., Cornett, E. S., Seifer, M. S., Kincaid, E. H. and Zvara, D. A., “Diagnosis of Intraoperative Aortic Dissection by Transesophageal Echocardiography During Routine Coronary Artery Bypass Surgery,” Anesthesia & Analgesia, 97, pp. 12541256 (2003).CrossRefGoogle Scholar
5.Acland, R. D., “Microvascular Anastomosis: Advice for Holding Stay Sutures and a New Vascular Clamp,” Surgery, 75, p. 185 (1974).Google Scholar
6.Gerty, S. D., “Endothelial Cell Damage by Temporary Arterial Occlusion with Surgical Clips: Study of Clip Site by Scanning and Transmission Electron Microscope,” Journal of Neurosurgery, 45, p. 514 (1976).CrossRefGoogle Scholar
7.Zhang, D., “Strive to Raise Microsurgery to a New Level,” Clinical Journal of Surgery, 19, p. 129 (1981).Google Scholar
8.Zhang, N., “The Animal Experiment on the Injury of Vascular Wall Caused by Vascular Clamp,” Chinese Journal of Surgery, 19, p. 474 (1981).Google Scholar
9.Wu, S., Chui, H., Li, J. and Zhang, L., “Air Pressure Vascular Clamp: Experimental Study and Clinical Application,” Chinese Journal of Surgery, 30, pp. 241243 (1992).Google ScholarPubMed
10.Auricchio, F., Di Loreto, M. and Sacco, E., “Finite-Element Analysis of a Stenotic Revascularization Through a Stent Insertion,” Computer Methods in Biomechanics and Biomedical Engineering, 4, pp. 249264 (2001).CrossRefGoogle Scholar
11.Gourisankaran, V. and Sharma, M. G., “The Finite-Element Analysis of Stresses in Atherosclerotic Arteries During Balloon Angioplasty,” Critical Reviews in Biomedical Engineering, 28, pp. 4751 (2000).CrossRefGoogle ScholarPubMed
12.Holzapfel, G. A., Eberlein, R., Wriggers, P. and Weizsäcker, H. W., “Large Strain Analysis of Soft Biological Membranes: Formulation and Finite-Element Analysis,” Computer Methods in Applied Mechanics and Engineering, 132, pp. 4561 (1996).CrossRefGoogle Scholar
13.Oh, S., Kleinberger, M. and McElhaney, J. H., “Finite-Element Analysis of Balloon Angioplasty,” Medical and Biological Engineering and Computing, 32, pp. S108S114 (1994).CrossRefGoogle ScholarPubMed
14.Gasser, T. C., Schulze-Bauer, C. A. J. and Holzapfel, G. A., “A Three-dimensional Finite Element Model for Arterial Clamping,” Journal for Biomechanics Engineering, ASME. 124, pp. 355363 (2002).CrossRefGoogle ScholarPubMed
15.Holzapfel, G. A., Stadler, M. and Schulze-Bauer, C. A. J., “A layer-Specific Three-Dimensional Model for the Simulation of Balloon Angioplasty Using Magnetic Resonance Imaging and Mechanical Testing,” Annals of Biomedical Engineering, 30, pp. 753767 (2002).CrossRefGoogle ScholarPubMed
16.Holzapfel, G. A. and Gasser, T. C., “Computational Stress-Deformation Analysis of Arterial Walls Including High-Pressure Response,” International Journal of Cardiology, 116, pp. 7885 (2007).CrossRefGoogle ScholarPubMed
17.Wen, C. Y. and Liu, C. G., Pressure Interrupter for Vascular Flow, Taiwan patent, No. M213631 (2004).Google Scholar
18. MSC Marc Operator's Manual, MSC Software Taiwan.Google Scholar
19.Mazumdar, J. N., Biofluid Mechanics, World Scientific, Inc., (1992)CrossRefGoogle Scholar
20.Xie, J., Chou, J. and Fung, Y. C., “Bending of Blood Vessel Wall: Stress-Strain Laws of the Intima-Media and Adventitial Layers,” Journal of Biomechanical Engineering, 117, pp. 136145 (1995).CrossRefGoogle ScholarPubMed