Numerical Evaluation of the Effect of Percentage and Location of Stenosis on the Hemodynamic Bifurcation of the Left Coronary Artery

Coronary arteries play a vital role in heart nutrition, and if they get stenosis, they will be at risk of developing a heart attack. Coronary artery disease is a progressive disease that is caused by the accumulation of fat particles on the wall of the arteries, leading to thickening of the wall and the formation of layers of plaque on the wall of the arteries and ultimately causing stenosis. In the present study, in order to obtain the effect of percentage and position of stenosis on the pattern of flow and WALL SHEAR STRESS distribution, followed by the progression of atherosclerotic plaques, left coronary artery and its main branches, the anterior and anterior artery, in different conditions according to Medina classification, 50 and 75%, and three different positions of lesion locations based on their distance from carina relative to the center of the branching were modeled. According to the results, WALL SHEAR STRESS and flow ratio and the percentage of inflow into the lateral branch decreased with increasing percentage of stenosis. For example, in Medina type (1.1.1), in 50% diameter stenosis, the flow ratio was 41% of the main branch and it was 37% in 75% diameter stenosis. WALL SHEAR STRESS values are less than 1, even 0.5 Pascal and in critical range in 75% diameter stenosis. Increasing the spacing of the plaque from the center of the branch, the WALL SHEAR STRESS and lateral branch flow ratio increase, and the likelihood of the expansion of the plaque decreases. Based on the development of stenosis severity, modal type (1.0.1) has the highest probability of developing atherosclerotic plaques and total vein occlusion compared to other types of medina.