Contegra conduit anastomoses

30 ‘circular’ vs. oblique ‘elliptical’ anastomosis extended on the left PA, evaluating pressure and velocity profiles, and shear stress, from PA 31 origin to the bifurcation. ‘Elliptical’ anastomosis provides larger (s54% difference) cross-sectional area than ‘circular’ anastomosis. Velocity 32 contours showed important stagnation at PA bifurcation in ‘circular’ anastomosis and minimal in ‘elliptical’ configuration, where fluid flow 33 occurred preferentially in left PA. Pressure contours showed peak pressure zone at bifurcation in ‘circular’ anastomosis, while ‘elliptical’ 34 exhibited more uniform pressure distribution. Shear stress distribution was more homogeneous in ‘elliptical’ than in ‘circular’ anastomosis. 35 At bifurcation and in right PA artery velocity and pressure were higher for ‘circular’ than ‘elliptical’ anastomosis, while in left PA velocity 36 was much higher for ‘elliptical’ anastomosis. CFD study demonstrates more homogeneous pressure, velocity and shear stress distributions 37 for ‘elliptical’ compared to ‘circular’ anastomosis at PA bifurcation, and preferential flow in left PA. CFD results suggest that clinical 38 application of ‘elliptical’ anastomosis, with cross-sectional area larger than conventional ‘circular’ anastomosis, may reduce incidence and 39 degree of distal stenosis, particularly for small size conduits. 4