Vortex generation in pulsatile flow through arterial bifurcation models including the human carotid artery

Visualization experiments were performed to elucidate the complicated flow pattern in pulsatile flow through arterial bifurcations. Human common carotid arteries, which were made transparent, and glass-models simulating Y- and T-shaped bifurcations were used. Pulsatile flow with wave forms similar to those of arterial flow was generated with a piston pump, elastic tube, airchamber, and valves controlling the outflow resistance. Helically recirculating flow with a pattern similar to that of the horseshoe vortex produced around wall-based protuberances in circular tubes was observed in pulsatile flow through all the bifurcations used in the present study. This flow type, which we shall refer to as the horseshoe vortex, has also been demonstrated to occur at the human common carotid bifurcation in steady flow with Reynolds numbers above 100. Time-varying flows also produced the horseshoe vortex mostly during the decelerating phase. Fluid particles of dye solution approaching the bifurcation apex diverged, divided into two directions perpendicularly, and then showed helical motion representing the horseshoe vortex formation. While this helical flow was produced, the stagnation points appeared on the wall upstream of the apex. Their position was dependent upon the flow distribution ratio between the branches in the individual arteries. The region affected by the horseshoe vortex was smaller during pulsatile flow than during steady flow. Lowering the Reynolds number together with the Womersley number weakened the intensity of helical flow. A separation bubble, resulting from the divergence or wall roughness, was observed at the outer or inner wall of the branch vessels and made the flow more complicated.     

Pulsatile flow during cardiopulmonary bypass preserves postoperative microcirculatory perfusion irrespective of systemic hemodynamics

The onset of nonpulsatile cardiopulmonary bypass is known to deteriorate microcirculatory perfusion, but it has never been investigated whether this may be prevented by restoration of pulsatility during extracorporeal circulation. We therefore investigated the distinct effects of nonpulsatile and pulsatile flow on microcirculatory perfusion during on-pump cardiac surgery. Patients undergoing coronary artery bypass graft surgery were randomized into a nonpulsatile (n = 17) or pulsatile (n = 16) cardiopulmonary bypass group. Sublingual mucosal microvascular perfusion was measured at distinct perioperative time intervals using sidestream dark field imaging, and quantified as the level of perfused small vessel density and microvascular flow index (vessel diameter < 20 μm). Microcirculation measurements were paralleled by hemodynamic and free hemoglobin analyses. The pulse wave during pulsatile bypass estimated 58 ± 17% of the baseline blood pressure waveform. The observed reduction in perfused vessel density during aorta cross-clamping was only restored in the pulsatile flow group and increased from 15.5 ± 2.4 to 20.3 ± 3.7 mm/mm(2) upon intensive care admission (P < 0.01). The median postoperative microvascular flow index was higher in the pulsatile group [2.6 (2.5-2.9)] than in the nonpulsatile group [2.1 (1.7-2.5); P = 0.001]. Pulsatile flow was not associated with augmentation of free hemoglobin production and was paralleled by improved oxygen consumption from 70 ± 14 to 82 ± 16 ml·min(-1)·m(-2) (P = 0.01) at the end of aortic cross-clamping. In conclusion, pulsatile cardiopulmonary bypass preserves microcirculatory perfusion throughout the early postoperative period, irrespective of systemic hemodynamics. This observation is paralleled by an increase in oxygen consumption during pulsatile flow, which may hint toward decreased microcirculatory heterogeneity during extracorporeal circulation and preservation of microcirculatory perfusion throughout the perioperative period.     

Visualization and finite element analysis of pulsatile flow in models of the abdominal aortic aneurysm

Pulsatile flows in glass models simulating fusiform and lateral saccular aneurysms were investigated by a flow visualization method. When resting fluid starts to flow, the initial fluid motion is practically irrotational. After a short period of time, the flow began to separate from the proximal wall of the aneurysm. Then the separation bubble or vortex grew rapidly in size and filled the whole area of the aneurysm circumferentially. During this period of time, the center of the vortex moved from the proximal end to the distal point of the aneurysm. The transient reversal flow, for instance, which may occur at the end of the ejection period, passed between the wall of the aneurysm and the centrally located vortex. When the rate and pulsatile frequency of flow were high, the vortex broke down into highly disturbed flow (or turbulence) at the distal portion of the aneurysm. The same effect was observed when the length of the aneurysm was increased. A reduction in pulsatile amplitude made the flow pattern close to that in steady flow. A finite element analysis was made to obtain velocity and pressure fields in pulsatile flow through a tube with an axisymmetric expansion. Calculations were performed with the pulsatile flows used in the visualization experiment in order to study the effects of change in the pulsatile wave form by keeping the time-mean Reynolds number and Womersley's parameter unchanged. Calculated instantaneous patterns of velocity field and stream lines agreed well with the experimental results. The appearance and disappearance of the vortex in the dilated portion and its development resulted in complex distributions of pressure and shear fields. Locally minimum and maximum values of wall shear stress occurred at points just upstream and downstream of the distal end of the expansion when the flow rate reached its peak.     

Pulsatile flow in a constricted channel.

A nonuniform channel is used as a simple model of a constricted arterial vessel. Flow patterns have been calculated for pulsatile flow with both sinusoidal and nonsinusoidal flow rates for a range of Reynolds number, Re, and Strouhal number, St. The results show that even for relatively low frequency flows a strong vortex wave will be generated with a complex wall shear stress distribution and peak values much greater than those found in steady or unsteady parallel flow. The vortex wave increases in strength with increasing Re and St, with its total length and wavelength independent of Re but inversely proportional to St. The form of the imposed flow rate is found to have an important effect on the flow and the shear stress distribution.     

Pulmonary vascular impedance and wave reflections in the hypoxic calf.

The alterations in pulsatile hemodynamics that occur during hypoxic pulmonary vasoconstriction have not been well characterized. Changes in oscillatory hemodynamics, however, may affect right ventricular-pulmonary vascular coupling and the dissipation of energy within the lung vasculature. To better define hypoxic pulsatile hemodynamics, we measured main pulmonary artery proximal and distal micromanometric pressures and ultrasonic flow in four open-chest calves during progressive hypoxia. Main pulmonary artery impedance and pressure transmission spectra were calculated using spectral analysis methods. Measured pressure and flow signals were separated in the time domain into forward and backward components. Hypoxia increased pulmonary blood pressure and resistance and produced multiple modifications in the impedance and pressure transmission spectra that indicated increased wave reflections and elasticity. The impedance and apparent phase velocity first-harmonic values were increased in amplitude, and the pressure transmission modulus plot showed an increased peak value. In addition, the impedance modulus plot demonstrated a rightward shift and increased oscillation in the mid- to high-frequency range. The time domain analysis also confirmed increased wave reflections and elasticity. Hypoxia produced large backward-traveling (reflected) pressure and flow waves. The initial portions of these waves arrived at the heart during systole, producing characteristic changes in the measured pressure and flow waveforms. With prolonged hypoxia, main pulmonary artery pulse wave velocity increased by 30%. Thus, hypoxia is associated with complex alterations in pulmonary artery elasticity and wave reflections that act to increase the oscillatory afterload of the right ventricle.     

Experimental study of finite amplitude pulsatile pressure waves in elastic tubes

An experimental study of the propagation of pulsatile pressure waves in an elastic tube was made and results were compared to a theoretical analysis by Lou. The pressure waves were sinusoidally varying acting in a horizontal, longitudinally constrained tube containing water. The independent experimental parameters varied were the pressure wave frequency, pressure wave volume per cycle, static tube pressure and steady flow rate. The wave propagation speeds, measured by non-intrusive techniques, were found to be functions of the wave frequency and the phase angles of the wave elements as theoretically predicted by Lou.     

Fast blood-flow simulation for large arterial trees containing thousands of vessels

Blood flow modelling has previously been successfully carried out in arterial trees to study pulse wave propagation using nonlinear or linear flow solvers. However, the number of vessels used in the simulations seldom grows over a few hundred. The aim of this work is to present a computationally efficient solver coupled with highly detailed arterial trees containing thousands of vessels. The core of the solver is based on a modified transmission line method, which exploits the analogy between electrical current in finite-length conductors and blood flow in vessels. The viscoelastic behaviour of the arterial-wall is taken into account using a complex elastic modulus. The flow is solved vessel by vessel in the frequency domain and the calculated output pressure is then used as an input boundary condition for daughter vessels. The computational results yield pulsatile blood pressure and flow rate for every segment in the tree. This solver is coupled with large arterial trees generated from a three-dimensional constrained constructive optimisation algorithm. The tree contains thousands of blood vessels with radii spanning ~1 mm in the root artery to ~30 μm in leaf vessels. The computation takes seconds to complete for a vasculature of 2048 vessels and less than 2 min for a vasculature of 4096 vessels on a desktop computer.     

Large-amplitude,short-wave peristalsis and its implications for transport

Valveless, tubular pumps are widespread in the animal kingdom, but the mechanism by which these pumps generate fluid flow is often in dispute. Where the pumping mechanism of many organs was once described as peristalsis, other mechanisms, such as dynamic suction pumping, have been suggested as possible alternative mechanisms. Peristalsis is often evaluated using criteria established in a technical definition for mechanical pumps, but this definition is based on a small-amplitude, long-wave approximation which biological pumps often violate. In this study, we use a direct numerical simulation of large-amplitude, short-wave peristalsis to investigate the relationships between fluid flow, compression frequency, compression wave speed, and tube occlusion. We also explore how the flows produced differ from the criteria outlined in the technical definition of peristalsis. We find that many of the technical criteria are violated by our model: Fluid flow speeds produced by peristalsis are greater than the speeds of the compression wave; fluid flow is pulsatile; and flow speed have a nonlinear relationship with compression frequency when compression wave speed is held constant. We suggest that the technical definition is inappropriate for evaluating peristalsis as a pumping mechanism for biological pumps because they too frequently violate the assumptions inherent in these criteria. Instead, we recommend that a simpler, more inclusive definition be used for assessing peristalsis as a pumping mechanism based on the presence of non-stationary compression sites that propagate unidirectionally along a tube without the need for a structurally fixed flow direction.     

Pulsatile flow of Casson's fluid through stenosed arteries with applications to blood flow

The effects of non-Newtonian nature of blood and pulsatility on flow through a stenosed tube have been investigated. A perturbation method is used to analyse the flow. It is of interest to note that the thickness of the viscous flow region is non-uniform (changing with axial distance). An analytic relation between viscous flow region thickness and red cell concentration has been obtained. It is important to mention that some researchers have obtained an approximate solution for the flow rate-pressure gradient equation (assuming the ratio between the yield stress and the wall shear to be very small in comparison to unity); in the present analysis, we have obtained an exact solution for this non-linear equation without making that assumption. The approximate and exact solutions compare well with one of the exact solutions. Another important result is that the mean and steady flow rates decrease as the yield stress theta increases. For the low values of the yield stress, the mean flow rate is higher than the steady flow rate, but for high values of the yield stress, the mean flow rate behaviour is of opposite nature. The critical value of the yield stress at which the flow rate behaviour changes from one type to another has been determined. Further, it seems that there exists a value of the yield stress at which flow stops for both the flows (steady and pulsatile). It is observed that the flow stop yield value for pulsatile flow is lower than the steady flow. The most notable result of pulsatility is the phase lag between the pressure gradient and flow rate, which is further influenced by the yield stress and stenosis. Another important result of pulsatility is the mean resistance to flow is greater than its steady flow value, whereas the mean value of the wall shear for pulsatile flow is equal to steady wall shear. Many standard results regarding Casson and Newtonian fluids flow, uniform tube flow and steady flow can be obtained as the special cases of the present analysis. Finally, some applications of this theoretical analysis have been cited.     

Interaction of peristaltic flow with pulsatile flow in a circular cylindrical tube

The effect of pulsatile flow on peristaltic transport in a circular cylindrical tube is analysed. The flow of a Newtonian viscous incompressible fluid in a flexible circular cylindrical tube on which an axisymmetric travelling sinusoidal wave is imposed, is considered. The initial flow in the tube is induced by an arbitrary periodic pressure gradient. A perturbation solution with amplitude ratio (wave amplitude/tube radius) as a parameter is obtained when the frequency of the travelling wave and that of the imposed pressure gradient are equal. The interaction effects of periodic wall induced flow and periodic pressure imposed flow are visualized through the presence of substantially different components of steady and higher harmonic oscillating flow in the first order flow solution. Numerical results show a strong variation of steady state velocity profiles with boundary wave number and Reynolds number and a strong phase shift behaviour of the flow in the radial direction.     

Computer simulation of firefly flash sequences.

A new method is proposed for measuring nonsteady flow rates when this flow is pulsatile in nature. This method involves the use of indicators and does not require direct access to the vessel carrying the fluid. No knowledge of the associated mathematics is required for its application. The investigator infuses indator into the vessel leading into a capillary or similar labyrinth at a time-varying rate such that the indicator concentration at the outflow from the labyrinth remains constant in time. When this condition at the outflow has been achieved, the pulsatile flow rate at the inflow is given simply as the ratio of the varying infusion rate to the constant outflow indicator concentration.     

Determination of pulsatile flow rates by indicator-dilution methods

A new method is proposed for measuring nonsteady flow rates when this flow is pulsatile in nature. This method involves the use of indicators and does not require direct access to the vessel carrying the fluid. No knowledge of the associated mathematics is required for its application. The investigator infuses indator into the vessel leading into a capillary or similar labyrinth at a time-varying rate such that the indicator concentration at the outflow from the labyrinth remains constant in time. When this condition at the outflow has been achieved, the pulsatile flow rate at the inflow is given simply as the ratio of the varying infusion rate to the constant outflow indicator concentration.     

Some flow visualization and laser-Doppler-velocity measurements in a true-to-scale elastic model of a human aortic arch--a new model technique.

Flow studies were done in an elastic true-to-scale silicone rubber model of an aortic arch to study further hemodynamic influences on atherosclerosis. The model was prepared from a cast of a young woman. A revised model technique was used. The model had a compliance similar to that of the human aortic arch. Velocity measurements were done in the model with a two component laser-Doppler-anemometer in steady and pulsatile flow using a calcium chloride solution with a viscosity of eta = 3.18 mPas and density of rho = 1.28 kg/m3 at 20 degrees C. The time average Reynolds numbers over a whole cycle in the ascending aorta was Re = 1350. The Womersley parameter for pulsatile flow was a = 20. The pulse wave velocity in the ascending aorta was about c = 5.4 m/sec. The secondary flow behavior was discussed for steady and pulsatile flow. Reverse flows were found, especially along the inner radius of the aortic arch in the descending aorta in steady and pulsatile flow and also in small areas of the ascending aorta and at the branches of the aortic arch. The formation of atherosclerotic plaques at preferred local flow regions is discussed.     

Effect of flow pulsatility on modeling the hemodynamics in the total cavopulmonary connection

Total cavopulmonary connection is the result of a series of palliative surgical repairs performed on patients with single ventricle heart defects. The resulting anatomy has complex and unsteady hemodynamics characterized by flow mixing and flow separation. Although varying degrees of flow pulsatility have been observed in vivo, non-pulsatile (time-averaged) boundary conditions have traditionally been assumed in hemodynamic modeling, and only recently have pulsatile conditions been incorporated without completely characterizing their effect or importance. In this study, 3D numerical simulations with both pulsatile and non-pulsatile boundary conditions were performed for 24 patients with different anatomies and flow boundary conditions from Georgia Tech database. Flow structures, energy dissipation rates and pressure drops were compared under rest and simulated exercise conditions. It was found that flow pulsatility is the primary factor in determining the appropriate choice of boundary conditions, whereas the anatomic configuration and cardiac output had secondary effects. Results show that the hemodynamics can be strongly influenced by the presence of pulsatile flow. However, there was a minimum pulsatility threshold, identified by defining a weighted pulsatility index (wPI), above which the influence was significant. It was shown that when wPI<30%, the relative error in hemodynamic predictions using time-averaged boundary conditions was less than 10% compared to pulsatile simulations. In addition, when wPI<50, the relative error was less than 20%. A correlation was introduced to relate wPI to the relative error in predicting the flow metrics with non-pulsatile flow conditions.     

Mechanical buckling of artery under pulsatile pressure

Tortuosity that often occurs in carotid and other arteries has been shown to be associated with high blood pressure, atherosclerosis, and other diseases. However the mechanisms of tortuosity development are not clear. Our previous studies have suggested that arteries buckling could be a possible mechanism for the initiation of tortuous shape but artery buckling under pulsatile flow condition has not been fully studied. The objectives of this study were to determine the artery critical buckling pressure under pulsatile pressure both experimentally and theoretically, and to elucidate the relationship of critical pressures under pulsatile flow, steady flow, and static pressure. We first tested the buckling pressures of porcine carotid arteries under these loading conditions, and then proposed a nonlinear elastic artery model to examine the buckling pressures under pulsatile pressure conditions. Experimental results showed that under pulsatile pressure arteries buckled when the peak pressures were approximately equal to the critical buckling pressures under static pressure. This was also confirmed by model simulations at low pulse frequencies. Our results provide an effective tool to predict artery buckling pressure under pulsatile pressure.     

Pulsatile flow and oxygen transport past cylindrical fiber arrays for an artificial lung: computational and experimental studies

The influence of time-dependent flows on oxygen transport from hollow fibers was computationally and experimentally investigated. The fluid average pressure drop, a measure of resistance, and the work required by the heart to drive fluid past the hollow fibers were also computationally explored. This study has particular relevance to the development of an artificial lung, which is perfused by blood leaving the right ventricle and in some cases passing through a compliance chamber before entering the device. Computational studies modeled the fiber bundle using cylindrical fiber arrays arranged in in-line and staggered rectangular configurations. The flow leaving the compliance chamber was modeled as dampened pulsatile and consisted of a sinusoidal perturbation superimposed on a steady flow. The right ventricular flow was modeled to depict the period of rapid flow acceleration and then deceleration during systole followed by zero flow during diastole. Experimental studies examined oxygen transfer across a fiber bundle with either steady, dampened pulsatile, or right ventricular flow. It was observed that the dampened pulsatile flow yielded similar oxygen transport efficiency to the steady flow, while the right ventricular flow resulted in smaller oxygen transport efficiency, with the decrease increasing with Re. Both computations and experiments yielded qualitatively similar results. In the computational modeling, the average pressure drop was similar for steady and dampened pulsatile flows and larger for right ventricular flow while the pump work required of the heart was greatest for right ventricular flow followed by dampened pulsatile flow and then steady flow. In conclusion, dampening the artificial lung inlet flow would be expected to maximize oxygen transport, minimize work, and thus improve performance.     

Two-equation turbulence modeling of pulsatile flow in a stenosed tube

The study of pulsatile flow in stenosed vessels is of particular importance because of its significance in relation to blood flow in human pathophysiology. To date, however, there have been few comprehensive publications detailing systematic numerical simulations of turbulent pulsatile flow through stenotic tubes evaluated against comparable experiments. In this paper, two-equation turbulence modeling has been explored for sinusoidally pulsatile flow in 75% and 90% area reduction stenosed vessels, which undergoes a transition from laminar to turbulent flow as well as relaminarization. Wilcox's standard k-omega model and a transitional variant of the same model are employed for the numerical simulations. Steady flow through the stenosed tubes was considered first to establish the grid resolution and the correct inlet conditions on the basis of comprehensive comparisons of the detailed velocity and turbulence fields to experimental data. Inlet conditions based on Womersley flow were imposed at the inlet for all pulsatile cases and the results were compared to experimental data from the literature. In general, the transitional version of the k-omega model is shown to give a better overall representation of both steady and pulsatile flow. The standard model consistently over predicts turbulence at and downstream of the stenosis, which leads to premature recovery of the flow. While the transitional model often under-predicts the magnitude of the turbulence, the trends are well-described and the velocity field is superior to that predicted using the standard model. On the basis of this study, there appears to be some promise for simulating physiological pulsatile flows using a relatively simple two-equation turbulence model.     

Computational fluid dynamic analysis of flow velocity waveform notching in umbilical arteries

Umbilical artery Doppler velocimetry waveform notching has long been associated with umbilical cord abnormalities, such as distortion, torsion, and/or compression (i.e., constriction). The physical mechanism by which the notching occurs has not been elucidated. Flow velocity waveforms (FVWs) from two-dimensional pulsatile flows in a constricted channel approximating a compressed umbilical cord are analyzed, leading to a clear relationship between the notching and the constriction. Two flows with an asymmetric, semi-elliptical constriction are computed using a stabilized finite-element method. In one case, the constriction blocks 75% of the flow passage, and in the other the constriction blocks 85%. Channel width and prescribed flow rates at the channel inflow are consistent with typical cord diameters and flow rates reported in the literature. Computational results indicate that waveform notching is caused by flow separation induced by the constriction, giving rise to a vortex (core) wave and associated eddies. Notching in FVWs based on centerline velocity (centerline FVW) is directly related to the passage of an eddy over the point of measurement on the centerline. Notching in FVWs based on maximum cross-sectional velocity (envelope FVW) is directly related to acceleration and deceleration of the fluid along the vortex wave. Results show that notching in envelope FVW is not present in flows with less than a 75% constriction. Furthermore, notching disappears as the vortex wave is attenuated at distances downstream of the constriction. In the flows with 75 and 85% constriction, notching of the envelope FVW disappears at ～3.8 and ～4.3 cm (respectively) downstream of the constriction. These results are of significant medical importance, given that envelope FVW is typically measured by commercial Doppler systems.     

Pulse wave velocity as a diagnostic index: the pitfalls of tethering versus stiffening of the arterial wall

Pulse wave velocity (PWV) is often used as a clinical index of aging, vascular disease, or age related hypertension. This practice is based on the assumption that a higher wave speed indicates vascular stiffening. This assumption is well grounded in the physics of pulsatile flow of an incompressible fluid where it is fully established that a pulse wave travels faster in a tube of stiffer wall, the wave speed becoming infinite in the mathematical limit of a rigid wall. However, in this paper we point out that the physical principal of higher pulse wave velocity in a stiffer tube is strictly valid only when the wall is free from outside constraints, which in the physiological setting is present in the form of tethering of the vessel wall. The use of PWV as an index of arterial stiffening may thus lose its validity if tethering is involved. A solution of the problem of vessel wall mechanics as they arise from the physiological pulsatile flow problem is presented for the purpose of resolving this issue. The vessel wall is considered to have finite thickness with or without tethering and with a range of mechanical properties ranging from viscoelastic to stiff. The results show that, indeed, while the wave speed becomes infinite in the mathematical limit of a rigid free wall, the opposite actually happens if the vessel wall is tethered. Here the wave speed actually diminishes as the degree of tethering increases. This dichotomy in the effects of tethering versus stiffening of the arterial wall may clearly lead to error in the interpretation of PWV as an index of vessel wall stiffness. In particular, a normal value of PWV may lead to the conclusion that vessel wall stiffening is absent while this value may in fact have been lowered by tethering. In other words, the diagnostic test may lead to a false negative diagnosis. Our results indicate that the reason for which PWV is lower in a tethered wall compared with that in a free wall of the same stiffness is that the radial movements of the wall are greatly reduced by tethering. More precisely, the results show that PWV depends strongly on the ratio of radial to axial displacements and that this ratio is much lower in a tethered wall than it is in a free wall of the same stiffness.     

The flow of a viscous liquid in a converging tube

The problem of the viscous flow of an incompressible Newtonian liquid in a converging tapered tube has been solved in spherical polar coordinates. The method of the solution involves the Stokes' stream function and a technique introduced by Stokes in the study of a sphere oscillating in a fluid. The theory for the flow in a rigid tube includes: (1) the pulsatile flow with both radial and angular velocity components; (2) the steady state flow with both radial and angular velocity components and (3) the very slow steady state flow with only a radial velocity component present. For a tapered elastic tube, the velocity of the propagated pulse wave is determined. The solution given is in terms of the elastic constants of the system and the coordinates for this type of geometry. The pulse velocity is then related to the velocity in an elastic cylindrical tube with the necessary correction terms to account for the tapered tube. Supported in part by the American Heart Association (No. 62F4EG). This work was done during the tenure of an Established Investigatorship of the American Heart Association.