Computed tomographic (CT) angiography often overestimates the significance of stenotic lesion of coronary and it leads to a need for functional diagnostic measurements. Currently, invasive pressure-wire-based fractional flow reserve (FFR) is becoming the standard of reference for assessing the physiological significance of coronary stenoses in clinical decisions regarding revascularization and exhibits favorable outcomes in identifying the ischemia-causing stenosis. A noninvasive approach for FFR prediction based on computational fluid dynamics with CT angiography was developed.
Since the hemodynamic conditions in distal vascular beds highly affects the coronary flow structures, it is necessary to incorporate zero-dimensional (0D) lumped parameter network (LPN) model for coronary microvascular flow by coupling with 3D CFD simulation. This demonstrated high diagnostic and prognostic accuracy with a reduction of adverse events. MPI parallel algorithm based on domain decomposition method was applied for the 3D-0D coupled model of coronary flow dynamics simulations in a monolithic approach.
In this paper, we introduce the development of clinically practical computational tool to estimate physiological significance of stenotic lesion of coronary with aims of accelerating clinical outcomes, basically by bench to bedside approach.