Comparison of left anterior descending coronary artery hemodynamics before and after angioplasty.
Coronary artery disease (CAD) is characterized by the progression of atherosclerosis, a complex pathological process involving the initiation, deposition, development, and breakdown of the plaque. The blood flow mechanics in arteries play a critical role in the targeted locations and progression of atherosclerotic plaque. In coronary arteries with motion during the cardiac contraction and relaxation, the hemodynamic flow field is substantially different from the other arterial sites with predilection of atherosclerosis. In this study, our efforts focused on the effects of arterial motion and local geometry on the hemodynamics of a left anterior descending (LAD) coronary artery before and after clinical intervention to treat the disease. Three-dimensional (3D) arterial segments were reconstructed at 10 phases of the cardiac cycle for both pre- and postintervention based on the fusion of intravascular ultrasound (IVUS) and biplane angiographic images. An arbitrary Lagrangian-Eulerian formulation was used for the computational fluid dynamic analysis. The measured arterial translation was observed to be larger during systole after intervention and more out-of-plane motion was observed before intervention, indicating substantial alterations in the cardiac contraction after angioplasty. The time averaged axial wall shear stress ranged from -0.2 to 9.5 Pa before intervention compared to -0.02 to 3.53 Pa after intervention. Substantial oscillatory shear stress was present in the preintervention flow dynamics compared to that in the postintervention case.
Ramaswamy
S D
SD
Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa 52242, USA.
Vigmostad
S C
SC
Wahle
A
A
Lai
Y G
YG
Olszewski
M E
ME
Braddy
K C
KC
Brennan
T M H
TM
Rossen
J D
JD
Sonka
M
M
Chandran
K B
KB
D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity; D001794:Blood Pressure; D003198:Computer Simulation; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery*; D003331:Coronary Vessels / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008955:Models, Cardiovascular; D011673:Pulsatile Flow; D033081:Shear Strength; D016896:Treatment Outcome