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Modelling and Simulation in Engineering
Volume 2012, Article ID 419087, 10 pages
Research Article

Determination of Flow Conditions in Coronary Bifurcation Lesions in the Context of the Medina Classification

1Department of Mechanical Engineering, McGill University, Montreal, QC, Canada H3A 0C3
2Department of Cardiovascular Surgery, Montreal Heart Institute, Montreal, QC, Canada H1T 1C8
3Quebec Heart-Lung Institute, Laval Hospital, Quebec City, QC, Canada G1V 4G5
4Faculty of Medicine, Laval University, Quebec City, QC, Canada G1V 0A6

Received 10 January 2012; Accepted 3 March 2012

Academic Editor: Guan Heng Yeoh

Copyright © 2012 Marjan Molavi Zarandi 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.


Coronary artery bifurcation lesions are complex and several classifications are presented to describe them. Recently, the Medina classification has been proposed. This classification uses binary values for characterization of stenosis. Flow conditions according to Medina classification have not been described. In this paper, bifurcation lesions corresponding to anatomical Medina lesion classification are compared on the basis of flow and Wall Shear Stress (WSS). Computational models of healthy and stenosed coronary artery bifurcations ((1, 1, 1), (0, 1, 1) and (1, 0, 1)) with moderate and severe stenoses of 50% and 75% diameter were analyzed. The results showed that, flow conditions vary in bifurcation lesion types according to the clinically-oriented Medina classification. The flow in SB of bifurcation was dependent of the Medina lesion type and was more affected in lesion type (1, 0, 1). The magnitudes of WSS on the inner and outer walls of SB of bifurcation lesion (1, 0, 1) in post-stenotic region and along the arterial wall were smaller than bifurcations lesions (0, 1, 1) and (1, 1, 1) respectively. Our results suggest that SB of bifurcation lesion (1, 0, 1) is more prone to atherosclerosis progression compared to types (0, 1, 1) and (1, 1, 1).