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

Mahmoud Maasrani, Issam Abouliatim, Majid Harmouche, Jean-Philippe Verhoye, Hervé Corbineau, Agnès Drochon

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DOI: 10.4236/jbise.2011.41005                

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.

Keywords

Coronary Disease; Off-Pump Surgery; Patients' Specific Simulations; Lumped Parameter Model

Conflicts of Interest

The authors declare no conflicts of interest.

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