Patient Specific Modelling of Blood Flow in Coronary ‎Artery

Authors

Department of Civil Engineering, Government Engineering College, Thrissur, Kerala, PIN:680009, India

Abstract

The performance of the heart is considerably affected by the blocks formed because of the deposition of ‎plaque inside the coronary artery. The blocks (stenosis) either in coronary artery or elsewhere force the ‎heart to work harder for pumping the oxygenated blood to the heart muscles and blood vessels. This ‎study analyses the flow through the stenosed coronary arteries via numerical modelling by using ANSYS ‎FLUENT software. Three real cases with different asymmetric stenosis levels (i.e., block level 33%, 66% ‎& 85%) are analysed by considering blood as a non-Newtonian fluid, and blood flow as pulsatile in ‎nature. As the flow regime falls in transition to turbulent region, the transition Shear Stress Transport ‎‎(SST) k-ω turbulence model is used to take care of the changeover stage from laminar to turbulent flow ‎and vice versa. The results show large variation both in Wall Shear Stress (WSS) and pressure drop near ‎the stenosis. Pressure drop becomes more significant at severe degrees of stenosis (66% and 85%) ‎compared to the mild case (33%). The study throws light on the critical distribution of shear stress and ‎pressure drop along the artery wall, which are considered as indicators of the commencement of heart ‎disease and further growth of stenosis. An indicator, viz., Fractional Flow Reserve (FFR), which relates ‎the percentage of stenosis to the pressure variations, can be used as an index to diagnose the severity of ‎stenosis. All the three cases with different stenotic levels were analysed under hyperaemic conditions and ‎found that even 45% stenosis case can go near to critical at hyperaemic flow conditions. The effect of ‎severity due to vessel constriction can be estimated by comparing the simulated pressure drop and WSS ‎before and after the stenosis, with the ones for a healthy artery. The present study developed a ‎methodology to calculate FFR value for unknown percentage of stenosis based on the simulated results ‎obtained from 33%, 66% and 85% stenosis. Thus, criticality of a patient with certain percentage stenosis ‎can also be evaluated. This simulation technique can be recommended as a non-invasive diagnostic tool ‎for the early detection of atherosclerosis‎‎.

Keywords


Volume 14, Issue 5 - Serial Number 61
September 2021
Pages 1469-1482
  • Received: 08 September 2020
  • Revised: 28 February 2021
  • Accepted: 02 March 2021
  • First Publish Date: 10 May 2021