Numerical evaluation of the effectiveness of coronary revascularization

Abstract

Abstract In the present paper we construct the model of coronary flow which utilizes the patient’s CT data on both large CA and perfusion. We reconstruct large coronary vessels based on the CT data and extrude possibly invisible vessels from the branches of the left coronary artery so that every terminal point supply every of standardized zone of myocardium. We apply a previously developed and validated 1D model of haemodynamics. Utilizing the patient-specific CTP data for modifying outflow terminal resistance at rest and under stress conditions is the major novelty of the present work. From our results it follows that acceptable values of fractional flow reserve (FFR) after the stenotic treatment may produce false negative output. Therefore healthy FFR values may be observed after ineffective revascularization. We also conclude that microvascular perfusion impairment plays significant role in correct computational estimation of haemodynamic indices before stenotic treatment. The advantage of the presented approach is the availability of transmural perfusion ratio assessment in everyday practice.