Evaluation of Hemodynamic Significance of Stenosis in Multiple Involvement of the Coronary Vessels by Mathematical Simulation

We use a mathematical model of one-dimensional blood flow in a network of blood vessels for in silico evaluation of hemodynamic significance of stenoses in multivessel coronary disease. Two cases were addressed: two stenosed vessels with different diameters and with the same degree of occlusion and two consecutive stenoses in the same vessel. We show that two criteria for the evaluation of hemodynamic significance based on the degree of stenosis and based on fractional flow reserve can give contradictory indications for surgical intervention. We also show that fractional flow reserve computation originally proposed for a single stenosis should be modified in the case of multivessel stenotic disease.