Numerical investigation of blood flow in three-dimensional porcine left anterior descending artery with various stenoses

Coronary heart disease causes obstruction of coronary blood flow and is the leading cause of death worldwide. The effect of focal stenosis on downstream flow pattern in the coronary arterial tree is not well understood. Here, the blood flows in normal and diseased porcine left anterior descending (LAD) arterial tree were modeled and compared to determine the effects of stenosis on the blood flow distribution and hemodynamic parameters. The anatomical model of LAD was extracted from a porcine heart by computed tomography (CT), which was comprised of a main trunk and nine side branches. Stenoses with various severities were imposed into the main trunk between the first and second side branches, and the boundary condition at each outlet accounted for the effect of stenosis on the flow rate in the downstream vasculature. It was found that only significant stenosis (≥75% area reduction) considerably altered pressure drop and total flow rate distribution in branches and at each bifurcation. The effect of significant stenosis on bifurcations, however, diminished at downstream locations. As demonstrated by distributions of oscillatory shear index and relative residence time, non-significant stenosis (<75% area reduction) has the potential to induce atherosclerosis near the ostium of downstream side branch, while significant stenosis can promote atherosclerosis in its wake.