Arteriovenous (AV) grafts for hemodialysis access typically have a high flow rate environment which creates significant pressure and velocity fluctuations downstream of venous anastomosis. We investigate a blood flow dynamics using direct numerical simulation within a subject-specific geometry with pulsatile flow conditions based on animal study. The irregularity of local geometry creates disturbed flow patterns and breaks the symmetry. This study demonstrates the importance of accurate representation of subject-specific geometry and realistic flow inlet conditions.

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