Patients' specific simulations of coronary fluxes in case of three-vessel disease

Abstract

In this work, we propose a model of the coronary circulation based on hydraulic/electric analogy. This model aims to provide quantitative estimations of the distribution of flows and pressures across the coro-nary network for patients with stenoses of the left main coronary artery (LMCA), left anterior de-scending artery (LAD) and left circumflex branch (LCx), and chronic occlusion of the right coronary artery (RCA), undergoing off-pump coronary sur-gery. The results of the simulations are presented for 10 patients with various stenoses grades and collat-eral supply. For each patient, the four revasculariza-tion situations (no graft operating, pathological situa-tion (0G); right graft only (1G), left grafts only (2G), complete revascularization (3G)) are considered. It is shown that: 1) the complete revascularization is fully justified for these patients because neither the right graft alone, nor the left grafts alone can ensure a suf-ficient perfusion improvement for the heart; 2) the capillary and collateral resistances (and the propor-tion between them) have a major impact on the flows and pressures everywhere in the network; 3) in the presence of the left grafts, the flows in the native stenosed arteries become low and this could promote the development of the native disease in these branches.