Vortex formation and recirculation zones in left anterior descending artery stenoses: computational fluid dynamics analysis

Katritsis, D. G., Theodorakakos, A., Pantos, I., Andriotis, A., Efstathopoulos, E. P., Siontis, G., Karcanias, N., Redwood, S. & Gavaises, M. (2010). Vortex formation and recirculation zones in left anterior descending artery stenoses: computational fluid dynamics analysis. Physics in Medicine and Biology, 55(5), 1395-.. doi: 10.1088/0031-9155/55/5/009

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Abstract

Flow patterns may affect the potential of thrombus formation following plaque rupture. Computational fluid dynamics (CFD) were employed to assess hemodynamic conditions, and particularly flow recirculation and vortex formation in reconstructed arterial models associated with ST-elevation myocardial infraction (STEMI) or stable coronary stenosis (SCS) in the left anterior descending coronary artery (LAD). Results indicate that in the arterial models associated with STEMI, a 50% diameter stenosis immediately before or after a bifurcation creates a recirculation zone and vortex formation at the orifice of the bifurcation branch, for most of the cardiac cycle, thus allowing the creation of stagnating flow. These flow patterns are not seen in the SCS model with an identical stenosis. Post-stenotic recirculation in the presence of a 90% stenosis was evident at both the STEMI and SCS models. The presence of 90% diameter stenosis resulted in flow reduction in the LAD of 51.5% and 35.9% in the STEMI models and 37.6% in the SCS model, for a 10 mmHg pressure drop. CFD simulations in a reconstructed model of stenotic LAD segments indicate that specific anatomic characteristics create zones of vortices and flow recirculation that promote thrombus formation and potentially myocardial infarction.

Item Type: Article
Additional Information: This is an author-created, un-copyedited version of an article accepted for publication in Physics in Medicine and Biology. The publisher is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at http://dx.doi.org/10.1088/0031-9155/55/5/009.
Uncontrolled Keywords: Myocardial infarction; left anterior descending; computational fluid dynamics
Subjects: Q Science > QA Mathematics
R Medicine > RC Internal medicine
Divisions: School of Engineering & Mathematical Sciences > Engineering
URI: http://openaccess.city.ac.uk/id/eprint/14037

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