The effect of angle on wall shear stresses in a LIMA to LAD anastomosis: numerical modelling of pulsatile flow.

The purpose of this study was to examine the effect of anastomotic angle on the flow patterns and wall shear distributions at the distal anastomosis of a left interior mammary artery (LIMA) graft to the left anterior descending artery (LDA). It is now well recognized that abnormal wall shear stress distributions along the anastomotic bed, around the toe, and around the heel can contribute to the focal development of intimal hyperplasia. However, the exact nature of the interaction between the dominant pulsing flow and the anastomotic angle on wall shear stresses has not been fully investigated numerically.