Seyyed Mahmoud Mousavi

The main medical cause of death in athletes is sudden cardiac death (SCD) (Harmon et al. 2014). SCD incidences are a function of age, and their causes are diverse (Virmani et al. 2001). Congenital coronary anomalies are the main observed cause of SCD in adults younger than age 35 (Virmani et al. 2001). Abnormal origin of the left coronary artery from the right sinus of Valsalva is the most lethal coronary artery anomaly which often leads to the arrhythmia especially during exercise (Virmani et al. 2001). An interarterial course, particularly when associated with an intramural segment, is the coronary abnormality most consistently associated with SCD (Agarwal et al. 2017). Why a patient may survive until adulthood with an asymptomatic congenital anomaly of the coronary artery, and then dies suddenly without superimposition of coronary atherosclerosis, remains intriguing (Frescura et al. 1998) (Rigatelli et al. 2019).

We hypothesize the blood supply of the coronary might change due to 1) its acute angle takeoff from the Valsalva sinus and 2) its interaction with the aorta wall (the intramural segment)

To investigate this hypothesis, we will combine the experimental data with numerical simulations to study and compare physiological flow fields, pressure in normal and abnormal coronary arteries under the rest and exercise conditions.

So far, we numerically studied the effects of boundary conditions and aortic valve functioning on coronary artery flow rates. We could observe that the choice of upstream boundary condition plays a significant role in coronary perfusion. Particularly, considering the model without valve, the inlet flow boundary condition provides better results than the inlet pressure boundary conditions. Instead, if the aortic valve is included, the inlet pressure boundary condition helps better simulate the coronary flow rates. In fact, in real human hearts, the left ventricular pressure acts on the upstream side of the aortic valve.