Patient-specific fluid-structure interaction simulation of the LAD-ITA bypass graft for moderate and severe stenosis: A doubt on the fractional flow reserve-based decision

• Autorzy: Tajeddini Farshad , Firoozabadi Bahar , Pakravan Hossein Ali , Ahmadi Tafti Seyed Hossein

Identyfikatory

DOI

10.1016/j.bbe.2021.12.003

• Języki publikacji: EN

Abstrakty

EN

Fractional flow reserve (FFR)-based decision improves the outcomes of percutaneous coronary intervention (PCI) for some patients, while its effectiveness in improving the results of coronary artery bypass graft (CABG) is unclear, in particular for moderate stenosis. It may be due to the fact that FFR cannot take into account the impacts of competitive flow (CF), intimal hyperplasia (IH), as well as compliance mismatch (CMM). As a result, two questions arise 1) whether FFR is a sufficient factor to decide to perform the CABG for patients with moderate to severe stenosis or not and 2) whether post-operative FFR shows the effectiveness of a graft. To shed light on this matter, two patient-specific models of LAD-ITA graft, consisting of two different severities of stenosis (moderate and severe), were simulated using two-way FSI simulation. It was observed that although both pre- and postoperative FFRs for moderate stenosis were higher, CF is more intense for moderate stenosis than severe one. Also, it was seen that CM and IH are more likely to occur in the bed, toe, and heel areas of a bypass graft performed for moderate stenosis. All in all, it can be concluded that in the case of moderate stenosis, pre- and post-operative FFRs might not be a suitable index for making the decision about performing or deferring CABG and also the effectiveness of the graft. Under such circumstances, it seems rational to use CFD in a wider range to investigate patients with moderate stenosis before the operation.

Słowa kluczowe

EN

FSI; CABG; FFR; fractional flow reserve; compliance mismatch; competitive flow; string phenomenon

PL

FSI; CABG; FFR; ułamkowa rezerwa przepływu; przepływ konkurencyjny

• Wydawca: Nałęcz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences ; Elsevier
• Czasopismo: Biocybernetics and Biomedical Engineering
• Rocznik: 2022
• Tom: Vol. 42, no. 1
• Strony: 143--157
• Opis fizyczny: Bibliogr. 57 poz., rys., tab., wykr.

Twórcy

autor

Tajeddini Farshad

• Center of Excellence in Energy Conversion, School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

autor

Firoozabadi Bahar

• Center of Excellence in Energy Conversion, School of Mechanical Engineering, Sharif University of Technology, Tehran, Iran

autor

Pakravan Hossein Ali

• School of Mechanical Engineering, Shiraz University, Shiraz, Iran

autor

Ahmadi Tafti Seyed Hossein

• Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Bibliografia

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