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Author:

Li, Bao (Li, Bao.) | Mao, Boyan (Mao, Boyan.) | Feng, Yue (Feng, Yue.) | Liu, Jincheng (Liu, Jincheng.) | Zhao, Zhou (Zhao, Zhou.) | Duan, Mengyao (Duan, Mengyao.) | Liu, Youjun (Liu, Youjun.) (Scholars:刘有军)

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Scopus SCIE PubMed

Abstract:

Clinically, fractional flow reserve (FFR)-guided coronary artery bypass grafting (CABG) is more effective than CABG guided by coronary angiography alone. However, no scholars have explained the mechanism from the perspective of hemodynamics. Two patients were clinically selected; their angiography showed 70% coronary stenosis, and the FFRs were 0.7 (patient 1) and 0.95 (patient 2). The FFR non-invasive computational model of the two patients was constructed by a 0-3D coupled multiscaled model, in order to verify that the model can accurately calculate the FFR results. Virtual bypass surgery was performed on these two stenoses, and a CABG multiscaled model was constructed. The flow rate of the graft and the stenosis coronary artery, as well as the wall shear stress (WSS) and the oscillatory shear index (OSI) in the graft were calculated. The non-invasive calculation results of FFR are 0.67 and 0.91, which are close to the clinical results, which proves that our model is accurate. According to the CABG model, the flow ratios of the stenosis coronary artery to the graft of patient 1 and patient 2 were 0.12 and 0.42, respectively. The time-average wall shear stress (TAWSS) results of patient 1 and patient 2 grafts were 2.09 and 2.16 Pa, respectively, and WSS showed uniform distribution on the grafts. The OSI results of patients 1 and 2 grafts were 0.0375 and 0.1264, respectively, and a significantly high OSI region appeared at the anastomosis of patient 2. The FFR value of the stenosis should be considered when performing bypass surgery. When the stenosis of high FFR values is grafted, a high OSI region is created at the graft, especially at the anastomosis. In the long term, this can cause anastomotic blockage and graft failure.

Keyword:

coronary artery bypass grafting hemodynamics lumped parameter model fractional flow reserve multiscale model

Author Community:

  • [ 1 ] [Li, Bao]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing, Peoples R China
  • [ 2 ] [Mao, Boyan]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing, Peoples R China
  • [ 3 ] [Feng, Yue]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing, Peoples R China
  • [ 4 ] [Liu, Jincheng]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing, Peoples R China
  • [ 5 ] [Liu, Youjun]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing, Peoples R China
  • [ 6 ] [Mao, Boyan]Beijing Univ Chinese Med, Sch Life Sci, Beijing, Peoples R China
  • [ 7 ] [Duan, Mengyao]Beijing Univ Chinese Med, Sch Life Sci, Beijing, Peoples R China
  • [ 8 ] [Feng, Yue]Peking Univ First Hosp, Dept Med Equipment, Beijing, Peoples R China
  • [ 9 ] [Zhao, Zhou]PeKing Univ Peoples Hosp, Cardiac Surg Dept, Beijing, Peoples R China

Reprint Author's Address:

  • 刘有军

    [Liu, Youjun]Beijing Univ Technol, Coll Life Sci & Bioengn, Beijing, Peoples R China

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Source :

FRONTIERS IN PHYSIOLOGY

ISSN: 1664-042X

Year: 2021

Volume: 12

4 . 0 0 0

JCR@2022

ESI Discipline: BIOLOGY & BIOCHEMISTRY;

ESI HC Threshold:84

JCR Journal Grade:1

Cited Count:

WoS CC Cited Count: 12

SCOPUS Cited Count: 14

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 2

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