To evaluate the local hemodynamic implications of coronary artery balloon angioplasty, computational fluid dynamics (CFD) was applied in a group of patients previously reported by [Wilson et al. (1988), 77, pp. 873–885] with representative stenosis geometry post-angioplasty and with measured values of coronary flow reserve returning to a normal range (3.6±0.3). During undisturbed flow in the absence of diagnostic catheter sensors within the lesions, the computed mean pressure drop was only about 1 mmHg at basal flow, and increased moderately to about 8 mmHg for hyperemic flow. Corresponding elevated levels of mean wall shear stress in the midthroat region of the residual stenoses, which are common after angioplasty procedures, increased from about 60 to 290 dynes/cm2 during hyperemia. The computations indicated that the pulsatile flow field was principally quasi-steady during the cardiac cycle, but there was phase lag in the pressure drop−mean velocity relation. Time-averaged pressure drop values, were about 20 percent higher than calculated pressure drop values, for steady flow, similar to previous in vitro measurements by Cho et al. (1983). In the throat region, viscous effects were confined to the near-wall region, and entrance effects were evident during the cardiac cycle. Proximal to the lesion, velocity profiles deviated from parabolic shape at lower velocities during the cardiac cycle. The flow field was very complex in the oscillatory separated flow reattachment region in the distal vessel where pressure recovery occurred. These results may also serve as a useful reference against catheter-measured pressure drops and velocity ratios (hemodynamic endpoints) and arteriographic (anatomic) endpoints post-angioplasty. Some comparisons to previous studies of flow through stenoses models are also shown for perspective purposes. [S0148-0731(00)00304-6]
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August 2000
Technical Papers
Physiological Flow Simulation in Residual Human Stenoses After Coronary Angioplasty
Rupak K. Banerjee, Staff Scientist,
Rupak K. Banerjee, Staff Scientist
Bioengineering and Physical Science Program, Bldg. 13, Rm. 3N17, National Institute of Health (NIH), Bethesda, MD 20892
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Lloyd H. Back, Fellow ASME,
Lloyd H. Back, Fellow ASME
Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109
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Martin R. Back, Assistant Professor of Surgery,,
Martin R. Back, Assistant Professor of Surgery,
Division of Vascular Surgery, University of South Florida, College of Medicine, Tampa, FL 33606
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Young I. Cho, Professor,
Young I. Cho, Professor,
Mechanical Engineering and Mechanics Department, Drexel University, Philadelphia, PA 19104
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Rupak K. Banerjee, Staff Scientist
Bioengineering and Physical Science Program, Bldg. 13, Rm. 3N17, National Institute of Health (NIH), Bethesda, MD 20892
Lloyd H. Back, Fellow ASME
Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109
Martin R. Back, Assistant Professor of Surgery,
Division of Vascular Surgery, University of South Florida, College of Medicine, Tampa, FL 33606
Young I. Cho, Professor,
Mechanical Engineering and Mechanics Department, Drexel University, Philadelphia, PA 19104
Contributed by the Bioengineering Division for publication in the JOURNAL OF BIOMECHANICAL ENGINEERING. Manuscript received by the Bioengineering Division March 23, 1999; revised manuscript received March 20, 2000. Associate Technical Editor: S. E. Rittgers.
J Biomech Eng. Aug 2000, 122(4): 310-320 (11 pages)
Published Online: March 20, 2000
Article history
Received:
March 23, 1999
Revised:
March 20, 2000
Citation
Banerjee, R. K., Back, L. H., Back, M. R., and Cho, Y. I. (March 20, 2000). "Physiological Flow Simulation in Residual Human Stenoses After Coronary Angioplasty ." ASME. J Biomech Eng. August 2000; 122(4): 310–320. https://doi.org/10.1115/1.1287157
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