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Particle depositions and related hemodynamic parameters in the multiple stenosed right coronary artery.

Bernad SI, Bernad ES, Craina M, Sargan I, Totoran A, Brisan C - J Clin Med Res (2012)

Bottom Line: Energy loss associated with such flow expansion after each constriction will be large and consequently the pressure drop will be higher.Overall pressure drop increased from 1700 Pa (12.75 mmHg) at the end diastole to 11000 Pa (82.5 mmHg) at the peak systole.However at the end of one cardiac cycle a percent of 1.4% (15 from 1063 particles release at the inlet section) remain inside the stenosed RCA.

View Article: PubMed Central - PubMed

Affiliation: Centre for Fundamental and Advanced Research, Romanian Academy - Timisoara Branch, Timisoara, Romania.

ABSTRACT

Background: Blood flow analysis of the human right coronary artery (RCA) has been carried out to investigate the effects of serial stenosis on coronary hemodynamics. A 3-D model of a serial stenosed RCA was reconstructed based on multislice computerized tomography images.

Methods: A velocity waveform in the proximal RCA and a pressure waveform in the distal RCA of a patient with a severe stenosis were acquired with a catheter delivered wire probe and applied as boundary conditions. The numerical analysis examines closely the effect of a multiple serial stenosis on the hemodynamic characteristics such as flow separation, wall shear stress (WSS) and particle depositions.

Results and conclusions: Energy loss associated with such flow expansion after each constriction will be large and consequently the pressure drop will be higher. Overall pressure drop increased from 1700 Pa (12.75 mmHg) at the end diastole to 11000 Pa (82.5 mmHg) at the peak systole. At the peak systole the WSS values reached 110 Pa in the stenosis with 28% diameter reduction and 210 Pa in the stenosis with 54% diameter reduction, which is high enough to damage the endothelial cells. However at the end of one cardiac cycle a percent of 1.4% (15 from 1063 particles release at the inlet section) remain inside the stenosed RCA.

No MeSH data available.


Related in: MedlinePlus

Patient-specific right coronary artery (RCA); (a) axial tomographic image which indicates a multiple coronary stenosis at the right coronary artery; geometry reconstruction (b) pericardial side, (c) epicardial side.
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Figure 1: Patient-specific right coronary artery (RCA); (a) axial tomographic image which indicates a multiple coronary stenosis at the right coronary artery; geometry reconstruction (b) pericardial side, (c) epicardial side.

Mentions: For the case presented in this paper, spiral CT (computed tomography) was performed for 4 days following the CA (coronary angiography) (44 year old, patient with typical angina symptoms is investigated). A Somatom Sensation 64 Scanner (Siemens Medical Systems, Erlangen, Germany) was used in non-enhanced spiral scan technique with a slice thickness of 2 mm, a table feed of 3 mm/s, and an increment of 2 mm. Data corresponding to the investigated patient is presented in Table 1. The CA and the spiral CT investigation detected a multiple severe right coronary artery (RCA) stenosis (Fig. 1). According to the NASCET (North American Symptomatic Carotid Endarterectomy Trial) [21] and ECST (European Carotid Surgery Trial) [22] method of stenosis classification, the stenoses severity is illustrated in Table 2. The percentage diameter reduction for a circular stenosis is 1-d/D, where d is the diameter of the lumen and D the diameter of the unoccluded artery.


Particle depositions and related hemodynamic parameters in the multiple stenosed right coronary artery.

Bernad SI, Bernad ES, Craina M, Sargan I, Totoran A, Brisan C - J Clin Med Res (2012)

Patient-specific right coronary artery (RCA); (a) axial tomographic image which indicates a multiple coronary stenosis at the right coronary artery; geometry reconstruction (b) pericardial side, (c) epicardial side.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3376876&req=5

Figure 1: Patient-specific right coronary artery (RCA); (a) axial tomographic image which indicates a multiple coronary stenosis at the right coronary artery; geometry reconstruction (b) pericardial side, (c) epicardial side.
Mentions: For the case presented in this paper, spiral CT (computed tomography) was performed for 4 days following the CA (coronary angiography) (44 year old, patient with typical angina symptoms is investigated). A Somatom Sensation 64 Scanner (Siemens Medical Systems, Erlangen, Germany) was used in non-enhanced spiral scan technique with a slice thickness of 2 mm, a table feed of 3 mm/s, and an increment of 2 mm. Data corresponding to the investigated patient is presented in Table 1. The CA and the spiral CT investigation detected a multiple severe right coronary artery (RCA) stenosis (Fig. 1). According to the NASCET (North American Symptomatic Carotid Endarterectomy Trial) [21] and ECST (European Carotid Surgery Trial) [22] method of stenosis classification, the stenoses severity is illustrated in Table 2. The percentage diameter reduction for a circular stenosis is 1-d/D, where d is the diameter of the lumen and D the diameter of the unoccluded artery.

Bottom Line: Energy loss associated with such flow expansion after each constriction will be large and consequently the pressure drop will be higher.Overall pressure drop increased from 1700 Pa (12.75 mmHg) at the end diastole to 11000 Pa (82.5 mmHg) at the peak systole.However at the end of one cardiac cycle a percent of 1.4% (15 from 1063 particles release at the inlet section) remain inside the stenosed RCA.

View Article: PubMed Central - PubMed

Affiliation: Centre for Fundamental and Advanced Research, Romanian Academy - Timisoara Branch, Timisoara, Romania.

ABSTRACT

Background: Blood flow analysis of the human right coronary artery (RCA) has been carried out to investigate the effects of serial stenosis on coronary hemodynamics. A 3-D model of a serial stenosed RCA was reconstructed based on multislice computerized tomography images.

Methods: A velocity waveform in the proximal RCA and a pressure waveform in the distal RCA of a patient with a severe stenosis were acquired with a catheter delivered wire probe and applied as boundary conditions. The numerical analysis examines closely the effect of a multiple serial stenosis on the hemodynamic characteristics such as flow separation, wall shear stress (WSS) and particle depositions.

Results and conclusions: Energy loss associated with such flow expansion after each constriction will be large and consequently the pressure drop will be higher. Overall pressure drop increased from 1700 Pa (12.75 mmHg) at the end diastole to 11000 Pa (82.5 mmHg) at the peak systole. At the peak systole the WSS values reached 110 Pa in the stenosis with 28% diameter reduction and 210 Pa in the stenosis with 54% diameter reduction, which is high enough to damage the endothelial cells. However at the end of one cardiac cycle a percent of 1.4% (15 from 1063 particles release at the inlet section) remain inside the stenosed RCA.

No MeSH data available.


Related in: MedlinePlus