Table of Contents
ISRN Vascular Medicine
Volume 2011, Article ID 470313, 10 pages
http://dx.doi.org/10.5402/2011/470313
Research Article

Coronary Flow in Patients with Three-Vessel Disease: Simulated Hemodynamic Variables in relation to Angiographically Assessed Collaterality and History of Myocardial Infarction

1Department of Thoracic and Cardiovascular Surgery, Rennes Hospital Center, 35000 Rennes, France
2Research Unit INSERM U642, Rennes 1, France
3UMR CNRS 6600, University of Technology of Compiègne, 60200 Compiègne, France
4Faculty of Sciences, Lebanese University, Tripoli, Lebanon

Received 11 November 2011; Accepted 18 December 2011

Academic Editor: I. Sipahi

Copyright © 2011 Issam Abouliatim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We study patients with stenoses of the left main coronary artery (LMCA), left anterior descending artery (LAD), and left circumflex branch (LCx) and with chronic occlusion of the right coronary artery (RCA), undergoing off-pump coronary surgery. An analog electrical model is used to provide quantitative estimations of the distribution of flows and pressures across the coronary network (in the stenosed native arteries, the collateral branches, the capillary areas, and so forth). The present paper demonstrates that the clinical information collected for the 10 patients included in the study (Rentrop score, history of myocardial infarction, left ventricular ejection fraction (LVEF)) are well correlated with the predicted hydrodynamic data. Patients with a good collaterality (Rentrop score = 3) or patients without anterior myocardial infarction have (i) less severe stenoses on the LMCA, (ii) lower microvascular resistances, (iii) higher grafts flow rates when the revascularization is performed, (iv) higher collateral flow rates towards the territory of the occluded artery, (v) better perfusion of this area, and (vi) better total perfusion of the heart.