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research-article

Reduced order models for transstenotic pressure drop in the coronary arteries

[+] Author and Article Information
Mehran Mirramezani

Mechanical Engineering, University of California Berkeley, CA, 94720; Mathematics, University of California Berkeley, CA, 94720
m.mirramezani@berkeley.edu

Scott Diamond

Chemical and Biomolecular Engineering, Institute for Medicine and Engineering, University of Pennsylvania, PA, 19104
sld@seas.upenn.edu

Harold Litt

Radiology, Perelman School of Medicine of the University of Pennsylvania, PA, 19104
harold.litt@uphs.upenn.edu

Shawn C. Shadden

Mechanical Engineering, University of California Berkeley, CA, 94720
shadden@berkeley.edu

1Corresponding author.

ASME doi:10.1115/1.4042184 History: Received June 22, 2018; Revised November 13, 2018

Abstract

The efficacy of reduced order modeling for transstenotic pressure drop in the coronary arteries is presented. Coronary artery disease is a leading cause of death worldwide and the computation of fractional flow reserve from computed tomography (FFRct) has become a standard for evaluating the functional significance of a coronary stenosis. FFRct uses 3D computational fluid dynamics to simulate coronary blood flow in order to compute transstenotic pressure drop during simulated hyperemia. In this study, we evaluate different fidelity hydrodynamic models and their ability to compute transstenotic pressure drop and FFRct in the coronary arteries. Models range from simple algebraic formulae to 1D, 2D and 3D time-dependent computational fluid dynamic simulations. Although several algebraic pressure-drop formulae have been proposed in the literature, these models were found to exhibit wide variation in predictions. Nonetheless, we demonstrate an algebraic formula that provides reliable predictions over a range of stenosis severity, morphology, location and flow rate when compared to the current standard for FFRct. The accounting of viscous dissipation, flow separation and pulsatile inertial effects were found to be the most significant contributions to accurate reduce order modeling of transstenotic coronary hemodynamics.

Copyright (c) 2018 by ASME
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