Boundary conditions in simulation of stenosed coronary arteries

A powerful alternative means to studying hemodynamics in diseased or healthy coronary arteries can be achieved by providing a numerical model in which blood flow can be virtually simulated, for instance, using the computational fluid dynamics (CFD) method. In fact, it is well documented that CFD allows reliable physiological blood flow simulation and measurements of flow parameters. A requisite for obtaining reliable results from coronary CFD is to use exact anatomical models and realistic boundary conditions. To date, in almost all of the modeling studies on hemodynamics of stenosed coronary arteries, a velocity based boundary conditions has been assigned. The objective of this study is to show that inlet velocity actually depends on the degree of stenosis and thus for severe constriction in coronary artery, a velocity based boundary conditions cannot be realistic. We then prove that regardless of severity of stenosis in coronary arteries, the upstream pressure, systemic pressure, is always constant, thus, should be used as boundary conditions instead. The two sets of boundary conditions are implemented to demonstrate the robustness of each in modeling of stenosed coronary artery in a CFD study. These boundary conditions are applied in a stenosed cylindrical pipe including three categories of symmetrical stenosis (mild, moderate and severe stenosis starting from 15 to 95% diameter reduction) for steady state and pulsatile flow. Results strongly indicate that inlet velocity boundary conditions are no longer valid when effective diameter in stenosis goes below approximately 2.8 mm (a healthy diameter is considered 3.2 mm) which corresponds to 10-15% diameter reduction. Further work will determine the effect of flow reduction on the oxygen tension in blood to better define conditions for clinical symptoms such as angina.