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research-article

DEVELOPMENT OF A COMPUTATIONAL FLUID DYNAMICS MODEL FOR MYOCARDIAL BRIDGING

[+] Author and Article Information
Ashkan Javadzadegan

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia; ANZAC Research Institute, The University of Sydney, Sydney, NSW 2139, Australia
ashkan.javadzadegan@mq.edu.au

Abouzar Moshfegh

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia; ANZAC Research Institute, The University of Sydney, Sydney, NSW 2139, Australia
abouzar.moshfegh@mq.edu.au

David Fulker

School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
dave_fulker@hotmail.com

Tracie J. Barber

School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
t.barber@unsw.edu.au

Yi Qian

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia
yi.qian@mq.edu.au

Leonard Kritharides

ANZAC Research Institute, The University of Sydney, Sydney, NSW 2139, Australia; Department of Cardiology, Concord Hospital, The University of Sydney, Sydney, NSW 2139, Australia
Leonard.Kritharides@sydney.edu.au

Andy S. C. Yong

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia; ANZAC Research Institute, The University of Sydney, Sydney, NSW 2139, Australia; Department of Cardiology, Concord Hospital, The University of Sydney, Sydney, NSW 2139, Australia
andysc.yong@gmail.com

1Corresponding author.

ASME doi:10.1115/1.4040127 History: Received November 04, 2017; Revised April 24, 2018

Abstract

The effect of myocardial bridging (MB) on coronary blood flow is complex, and the local haemodynamic changes are not well understood. Computational fluid dynamics (CFD) modelling of MB remains challenging due to its dynamic and phasic nature. Three-dimensional (3D) model of the left anterior descending (LAD) coronary artery of a patient with MB was reconstructed by fusion of coronary angiography and intravascular ultrasound. A moving-boundary CFD algorithm was developed to simulate the patient-specific muscle compression caused by MB. The algorithm incorporates the electrocardiogram to synchronise with the cardiac cycle, bridge characteristics to mimic the 3D and dynamic nature of MB, and physiology data including intracoronary pressure waveforms to implement as boundary conditions. A second simulation was performed with the bridge artificially removed to determine the haemodynamics in the same vessel in the absence of MB. The difference between average wall shear stress (WSS) in the proximal and bridge segments for the model with MB was significantly different than those for the model without MB (proximal segment: 0.32 ± 0.14 Pa (with MB) vs 0.97 ± 0.39 Pa (without MB), P < 0.0001 — bridge segment: 2.60 ± 0.94 Pa (with MB) vs 1.50 ± 0.64 Pa (without MB), P < 0.0001). The presence of MB resulted in haemodynamic abnormalities in the arterial segments proximal to the bridge including low WSS and flow recirculation zones, whereas segments within the bridge exhibited haemodynamic patterns which tend to discourage atheroma development.

Copyright (c) 2018 by ASME
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