Complex Coronary Hemodynamics - Simple Analog Modelling as an Educational Tool

Gaurav R. Parikh1, Elvis Peter2, Nikolaos Kakouros1, *
1 Division of Cardiovascular Medicine, University of Massachusetts, 55 Lake Ave North, Worcester, MA, 01655. USA
2 Department of Cardiology, Marshfield Clinic, Weston Center 3501 Cranberry Blvd, Weston, WI 54476, USA

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© 2017 Parikh et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this authors at Division of Cardiovascular Medicine, University of Massachusetts, 55 Lake Ave North, Worcester, MA, 01655, USA, Tel: 774- 441-6310, Fax: 774-441-6303; E-mail:



Invasive coronary angiography remains the cornerstone for evaluation of coronary stenoses despite there being a poor correlation between luminal loss assessment by coronary luminography and myocardial ischemia. This is especially true for coronary lesions deemed moderate by visual assessment. Coronary pressure-derived fractional flow reserve (FFR) has emerged as the gold standard for the evaluation of hemodynamic significance of coronary artery stenosis, which is cost effective and leads to improved patient outcomes. There are, however, several limitations to the use of FFR including the evaluation of serial stenoses.


In this article, we discuss the electronic-hydraulic analogy and the utility of simple electrical modelling to mimic the coronary circulation and coronary stenoses. We exemplify the effect of tandem coronary lesions on the FFR by modelling of a patient with sequential disease segments and complex anatomy.


We believe that such computational modelling can serve as a powerful educational tool to help clinicians better understand the complexity of coronary hemodynamics and improve patient care.

Keywords: Coronary angiography, Myocardial fractional flow reserve, Computational modelling, Coronary hemodynamics, System equivalence, Educational tools.