Numerical analysis of the pressure drop across highly-eccentric coronary stenoses: application to the calculation of the fractional flow reserve

Biomedical Engineering Online
R AgujetasJ M Montanero

Abstract

Fractional flow reverse (FFR) is the gold standard assessment of the hemodynamic significance of coronary stenoses. However, it requires the catheterization of the coronary artery to determine the pressure waveforms proximal and distal to the stenosis. On the contrary, computational fluid dynamics enables the calculation of the FFR value from relatively non-invasive computed tomography angiography (CTA). We analyze the flow across idealized highly-eccentric coronary stenoses by solving the Navier-Stokes equations. We examine the influence of several aspects (approximations) of the simulation method on the calculation of the FFR value. We study the effects on the FFR value of errors made in the segmentation of clinical images. For this purpose, we compare the FFR value for the nominal geometry with that calculated for other shapes that slightly deviate from that geometry. This analysis is conducted for a range of stenosis severities and different inlet velocity and pressure waveforms. The errors made in assuming a uniform velocity profile in front of the stenosis, as well as those due to the Newtonian and laminar approximations, are negligible for stenosis severities leading to FFR values around the threshold 0.8. The limited re...Continue Reading

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Citations

Jan 16, 2021·International Journal for Numerical Methods in Biomedical Engineering·Simeon SkopalikManosh C Paul
Feb 11, 2021·Computer Methods in Biomechanics and Biomedical Engineering·Zhuxiang XiongYubo Fan
May 7, 2021·Computers in Biology and Medicine·Jorge Dueñas-PamplonaJosé Ramón López-Mínguez
Jul 3, 2020·Computer Methods and Programs in Biomedicine·Haipeng LiuDingchang Zheng
Dec 7, 2021·Wiener klinische Wochenschrift·Samuel A FreitasGabriel de O Ramos

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