Validation of boundary conditions for coronary circulation model based on a lumped parameter approach

Abstract

Abstract In the present work, we construct a model of coronary flow, which utilizes both CT scans of large coronary arteries and coronary CT perfusion. The model describes pulsatile flow in the patient’s network of coronary vessels and takes into account a number of physiological effects: myocardium contractions, stenoses, impairment of microvascular perfusion. The main novelty of this model is the new smooth boundary conditions that have not been used before in patient-specific simulations of coronary circulation. New boundary conditions use 0D lumped model approach and provide asymptotic convergence of the solution for the cases of one-to-one vascular connection and bifurcation with a very thin child vessel. The new boundary conditions make it possible to estimate the fractional flow margin more accurately. We also studied sensitivity of haemodynamic indices (fractional flow reserve, coronary flow reserve, instantaneous wave-free ratio) to the variations of microcirculation impairment. No substantial difference in sensitivity was observed between new model and original approach. The advantage of the presented approach is the availability of the required data in everyday clinical practice and, thus, improved personalization of the model.