Coronary artery diseaseValidation of Functional State of Coronary Tandem Lesions Using Computational Flow Dynamics
Section snippets
Methods
To validate the study hypothesis, we developed CFD modeling for coronary tandem lesions. Figure 1 shows a schematic figure of a simulated coronary tandem lesion. We made a total of 147 combinations of the proximal (stenosis A, 30% to 90% diameter stenosis, increasing in increments of 10%) and distal (stenosis B, 30% to 90% diameter stenosis, increasing in increments of 10%) stenoses with distances of 10, 20, and 30 mm. Herein, percentage diameter stenosis created in the simulation is equivalent
Results
A total of 147 combinations of stenosis A and stenosis B were created. The change in FFR according to the differing stenosis severity of the other stenosis is shown in Figure 2. Figure 3 plots the relation between the differences in diameter stenosis of stenoses A and B and the differences in ΔFFR (A) and ΔFFR (B). Furthermore, the experimental results of Pijls et al2 were plotted for the external validation of our simulated results in Supplemental Figure 1. Figure 2 and Supplemental Figure 1
Discussion
In vitro assessment and CFD modeling in the present study demonstrated that ΔFFR corresponds to relative functional severity within functionally significant coronary tandem lesions. On the basis of this theory, treatment for an individual stenosis within a coronary tandem lesion could be prioritized by ΔFFR for treating patients with significant coronary tandem lesions, such as first treating the lesion with large ΔFFR and subsequently reassessing the FFR for the remaining lesion. As a result,
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This study was funded by Grant A102065 from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea, and by the Cardiovascular Research Foundation, Seoul, Korea.