Numerical study on the impact of central venous catheter placement on blood flow in the cavo-atrial junction Journal Article
| Authors: | Su, B.; Palahnuk, H.; Harbaugh, T.; Rizk, E.; Hazard, W.; Chan, A.; Bernstein, J.; Weinsaft, J. W.; Manning, K. B. |
| Article Title: | Numerical study on the impact of central venous catheter placement on blood flow in the cavo-atrial junction |
| Abstract: | An in silico study is performed to investigate fluid dynamic effects of central venous catheter (CVC) placement within patient-specific cavo-atrial junctions. Prior studies show the CVC infusing a liquid, but this study focuses on the placement without any liquid emerging from the CVC. A 7 or 15-French double-lumen CVC is placed virtually in two patient-specific models; the CVC tip location is altered to understand its effect on the venous flow field. Results show that the CVC impact is trivial on flow in the superior vena cava when the catheter-to-vein ratio ranges from 0.15 to 0.33. Results further demonstrate that when the CVC tip is directly in the right atrium, flow vortices in the right atrium result in elevated wall shear stress near the tip hole. A recirculation region characterizes a spatially variable flow field inside the CVC side hole. Furthermore, flow stagnation is present near the internal side hole corners but an elevated wall shear stress near the curvature of the side hole’s exit. These results suggest that optimal CVC tip location is within the superior vena cava, so as to lower the potential for platelet activation due to elevated shear stresses and that CVC geometry and location depth in the central vein significantly influences the local CVC fluid dynamics. A thrombosis model also shows thrombus formation at the side hole and tip hole. After modifying the catheter design, the hemodynamics change, which alter thrombus formation. Future studies are warranted to study CVC design and placement location in an effort to minimize CVC-induced thrombosis incidence. © The Author(s) under exclusive licence to Biomedical Engineering Society 2024. |
| Keywords: | clinical article; controlled study; retrospective study; simulation; geometry; thrombosis; micro-computed tomography; computer model; blood flow; hemodynamics; diseases; blood vessels; image reconstruction; magnetic resonance angiography; thrombocyte activation; central venous catheter; location; central venous catheters; shear stress; shear flow; heart atrium; heart atria; superior cava vein; vena cava, superior; catheters; cardiovascular magnetic resonance; humans; human; article; patient specific; particle image velocimetry; central vein; clotting; computational fluid dynamics; cardiovascular devices; patient-specific venous model; thrombosis model; virtual insertion; flow fields; velocity measurement; central venoi catheter; image velocimetry; particle images; patient-specific venoi model; thrombose model; cavoatrial junction; heart cycle; shear rate |
| Journal Title: | Annals of Biomedical Engineering |
| Volume: | 52 |
| Issue: | 5 |
| ISSN: | 0090-6964 |
| Publisher: | Springer |
| Date Published: | 2024-05-01 |
| Start Page: | 1378 |
| End Page: | 1392 |
| Language: | English |
| DOI: | 10.1007/s10439-024-03463-7 |
| PUBMED: | 38407724 |
| PROVIDER: | scopus |
| PMCID: | PMC11904431 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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