Patient-Specific In-Silico Hemodynamic Analysis of the Anomalous Aortic Origin of the Coronary Artery (AAOCA)

Anomalous aortic origin of the coronary artery (AAOCA) can lead to ischemia and abrupt mortality. This study investigates the hemodynamic effects of AAOCA with various take-off angles and ostium shapes using computational fluid dynamics (CFD) simulations. The research utilizes patient-specific coronary artery geometry reconstructed from a computed tomography coronary angiogram (CTCA), focusing on the left coronary artery (LCA). The results indicate that as the take-off angle of the LCA narrows, the ostium shape becomes more horizontally elliptical, leading to increased wall shear stress (WSS) and WSS-based indices such as time-averaged wall shear stress (TAWSS) and transverse wall shear stress (transWSS). Furthermore, the analysis of fractional flow reserve (FFR) provides valuable insights into the physiological significance. These findings highlight the potential risk factors associated with AAOCA and emphasize the importance of understanding how hemodynamic changes may contribute to coronary artery disease and clinical management.