RT Journal Article
T1 Sensitivity Analysis of In Silico Fluid Simulations to Predict Thrombus Formation after Left Atrial Appendage Occlusion
A1 Mill, Jordi
A1 Agudelo, Victor
A1 Olivares, Andy L.
A1 Pons, Maria Isabel
A1 Silva, Etelvino
A1 Nuñez Garcia, Marta
A1 Morales, Xabier
A1 Arzamendi, Dabit
A1 Freixa, Xavier
A1 Noailly, Jérôme
A1 Camara, Oscar
K1 Sensitivity analysis
K1 Boundary conditions
K1 Computational fluid dynamics
K1 Dynamic mesh
K1 Device-related thrombus
K1 Left atrium
K1 Left atrial appendage
K1 Hidrodinámica
K1 Trombosis
K1 Atrios cardíacos
K1 Apéndice atrial
K1 Enfermedades cardiovasculares
K1 Fibrilación auricular
AB Atrial fibrillation (AF) is nowadays the most common human arrhythmia and it is consid ered a marker of an increased risk of embolic stroke. It is known that 99% of AF-related thrombi are generated in the left atrial appendage (LAA), an anatomical structure located within the left atrium (LA). Left atrial appendage occlusion (LAAO) has become a good alternative for nonvalvular AF patients with contraindications to anticoagulants. However, there is a non-negligible number of device-related thrombus (DRT) events, created next to the device surface. In silico fluid simulations can be a powerful tool to better understand the relation between LA anatomy, haemodynamics, and the process of thrombus formation. Despite the increasing literature in LA fluid modelling, a consensus has not been reached yet in the community on the optimal modelling choices and boundary conditions for generating realistic simulations. In this line, we have performed a sensitivity analysis of several boundary conditions scenarios, varying inlet/outlet and LA wall movement configurations, using patient-specific imaging data of six LAAO patients (three of them with DRT at follow-up). Mesh and cardiac cycle convergence were also analysed. The boundary conditions scenario that better predicted DRT cases had echocardiography-based velocities at the mitral valve outlet, a generic pressure wave from an AF patient at the pulmonary vein inlets, and a dynamic mesh approach for LA wall deformation, emphasizing the need for patient-specific data for realistic simulations. The obtained promising results need to be further validated with larger cohorts, ideally with ground truth data, but they already offer unique insights on thrombogenic risk in the left atria.
PB MDPI
YR 2021
FD 2021-09-18
LK http://hdl.handle.net/10668/3918
UL http://hdl.handle.net/10668/3918
LA en
NO Mill J, Agudelo V, Olivares  AL,  Pons MI, Silva E, Nuñez-Garcia M et al. Sensitivity Analysis of In-Silico Fluid Simulations to Predict Thrombus Formation after Left Atrial Appendage Occlusion. Mathematics 2021, 9, 2304
DS RISalud
RD Apr 11, 2025