Fluid-Elastic Versus Computational Fluid Dynamics Techniques in the Biomechanical Analysis of Coronary Arteries

In this paper we develop a simplified biomechanical model of a segment of the left anterior descending (LAD) coronary artery (CA), using both fluid-elastic and computational fluid dynamics techniques to predict the location which is prone to a spontaneous coronary artery dissection (SCAD); the focus is on the differences and similarities of the predictions based on the fluid-elastic and computational dynamics techniques. SCAD is defined as a nonatherosclerotic dissection, by which a tear in the intima layer of the CA develops into a false lumen or intramural hematoma. Eventually, this false lumen or intramural hematoma compromises coronary blood flow, resulting in subsequent acute myocardial infarction (AMI). SCAD is now recognised as a prevalent cause of AMI in healthy, young, peri or post-partum women, but still remains an under researched area in biomechanics. Both the fluid-elastic and computational fluid dynamics methods have previously been used to analyse the biomechanics of the myocardium, including modelling of the aorta and atherosclerotic arteries, however, the debate on the efficacy of each method continues. This paper highlights that employing the fluid-elastic technique (in comparison to employing the fluid dynamics technique) is of the essence for accurate SCAD predictions. Observing the differences between the two computational methods will shape the way in which SCAD should be best modelled. In the future, this will allow for the most accurate biomechanical analysis of SCAD to assist in preventing AMI in healthy, young, and peri or post-partum women.