Particle depositions and related hemodynamic parameters in the multiple stenosed right coronary artery

J Clin Med Res. 2012 Jun;4(3):177-89. doi: 10.4021/jocmr843w. Epub 2012 May 15.

Abstract

Background: Blood flow analysis of the human right coronary artery (RCA) has been carried out to investigate the effects of serial stenosis on coronary hemodynamics. A 3-D model of a serial stenosed RCA was reconstructed based on multislice computerized tomography images.

Methods: A velocity waveform in the proximal RCA and a pressure waveform in the distal RCA of a patient with a severe stenosis were acquired with a catheter delivered wire probe and applied as boundary conditions. The numerical analysis examines closely the effect of a multiple serial stenosis on the hemodynamic characteristics such as flow separation, wall shear stress (WSS) and particle depositions.

Results and conclusions: Energy loss associated with such flow expansion after each constriction will be large and consequently the pressure drop will be higher. Overall pressure drop increased from 1700 Pa (12.75 mmHg) at the end diastole to 11000 Pa (82.5 mmHg) at the peak systole. At the peak systole the WSS values reached 110 Pa in the stenosis with 28% diameter reduction and 210 Pa in the stenosis with 54% diameter reduction, which is high enough to damage the endothelial cells. However at the end of one cardiac cycle a percent of 1.4% (15 from 1063 particles release at the inlet section) remain inside the stenosed RCA.

Keywords: Flow separation; Numerical simulation; Pressure drop; Wall shear stress.