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THE INFLUENCES OF SWIRL FLOW ON FRACTIONAL FLOW RESERVE IN MILD/MODERATE/SEVERE STENOTIC CORONARY ARTERIAL MODELS

관상동맥 내의 나선형 유동이 협착도에 따라 분획 혈류 예비능에 미치는 영향에 관한 수치해석

  • Lee, Kyung Eun (Department of Mechanical and Biomedical Engineering, Kangwon National University) ;
  • Kim, Gook Tae (Department of Mechanical and Biomedical Engineering, Kangwon National University) ;
  • Ryu, Ah-Jin (Department of Mechanical and Biomedical Engineering, Kangwon National University) ;
  • Shim, Eun Bo (Department of Mechanical and Biomedical Engineering, Kangwon National University)
  • 이경은 (강원대학교 기계의용공학과) ;
  • 김국태 (강원대학교 기계의용공학과) ;
  • 류아진 (강원대학교 기계의용공학과) ;
  • 심은보 (강원대학교 기계의용공학과)
  • Received : 2017.01.05
  • Accepted : 2017.03.15
  • Published : 2017.03.31

Abstract

Swirl flow is often found in proximal coronary arteries, because the aortic valves can induce swirl flows in the coronary artery due to vortex formation. In addition, the curvature and tortuosity of arterial configurations can also produce swirl flows. The present study was performed to investigate fractional flow reserve alterations in a post-stenotic distal part due to the presence of pre-stenotic swirl flow by computational fluid dynamics analysis for virtual stenotic models by quantifying fractional flow reserve(FFR). Simplified stenotic coronary models were divided into those with and without pre-stenotic swirl flow. Various degrees of virtual stenosis were grouped into three grades: mild, moderate, and severe, with degree of stenosis of 0 ~ 40%, 50 ~ 60%, and 70 ~ 90%, respectively. In this study, three-dimensional computational hemodynamic simulations were performed under hyperemic conditions in virtual stenotic coronary models by coupling with a zero-dimensional lumped parameter model. The results showed that the influence of pre-stenotic swirl inflow is dominant on FFR alteration in mild stenosis, whereas stenosis is dominant on FFR alteration in moderate/severe stenosis. The decrease in FFR caused by swirl flow is more significant in mild stenosis than moderate/severe stenosis. Biomechanical modeling is useful for clinicians to provide insight for medical intervention strategies. This hemodynamic-based parameter study could play a critical role in the development of a non-invasive imaging-based strategy-support system for percutaneous transluminal angioplasty in cases of mild/moderate stenosis.

Keywords

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