Characterizing left atrial appendage functions in sinus rhythm and atrial fibrillation using computational models

Zhang, Lucy T.

doi:10.1016/j.jbiomech.2008.05.012

Cited by 63 publications

(46 citation statements)

References 44 publications

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“…It has been successfully used to model various biomechanics applications including shear-induced red blood cell deformation [49], stent deployment [50], and flow in cardiovascular systems [51]. This numerical technique provides the flexibilities in handling varying shapes of embedded structures.…”

Section: Immersed Finite Element Methodsmentioning

confidence: 99%

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Zhang

2008

Numerical Methods in Fluids

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SUMMARYNumerical analysis of pulsatile blood flow in healthy, stenosed, and stented carotid arteries is performed with the aim of identifying hemodynamic factors in the initiation, growth, and the potential of leading to severe occlusions of a diseased artery. The Immersed Finite Element Method is adopted for this study to conveniently incorporate various geometrical shapes of arteries without remeshing. Our computational results provide detailed quantitative analysis on the blood flow pattern, wall shear stress, particle residence time, and oscillatory shear index. The analysis of these parameters leads to a better understanding of blood clot formation and its localization in a stenosed and a stented carotid artery. A healthy artery is also studied to establish a baseline comparison. This analysis will assist in developing treatments for diseased arteries and novel stent designs to reduce restenosis.

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Section: Immersed Finite Element Methodsmentioning

confidence: 99%

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Zhang

2008

Numerical Methods in Fluids

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“…Few works in the literature present experimental and numerical studies analysing the flow patterns in the LA (18, 19), with some including the LAA in the model (20) and considering AF conditions (21–24). However, a direct comparison of different LAA morphologies with the onset of different hemodynamic parameters has not been produced yet.…”

Section: Introductionmentioning

confidence: 99%

Computational Fluid Dynamic Analysis of the Left Atrial Appendage to Predict Thrombosis Risk

Bosi

Cook

Rai

et al. 2018

Front. Cardiovasc. Med.

114

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During Atrial Fibrillation (AF) more than 90% of the left atrial thrombi responsible for thromboembolic events originate in the left atrial appendage (LAA), a complex small sac protruding from the left atrium (LA). Current available treatments to prevent thromboembolic events are oral anticoagulation, surgical LAA exclusion, or percutaneous LAA occlusion. However, the mechanism behind thrombus formation in the LAA is poorly understood. The aim of this work is to analyse the hemodynamic behaviour in four typical LAA morphologies - “Chicken wing”, “Cactus”, “Windsock” and “Cauliflower” - to identify potential relationships between the different shapes and the risk of thrombotic events. Computerised tomography (CT) images from four patients with no LA pathology were segmented to derive the 3D anatomical shape of LAA and LA. Computational Fluid Dynamic (CFD) analyses based on the patient-specific anatomies were carried out imposing both healthy and AF flow conditions. Velocity and shear strain rate (SSR) were analysed for all cases. Residence time in the different LAA regions was estimated with a virtual contrast agent washing out. CFD results indicate that both velocity and SSR decrease along the LAA, from the ostium to the tip, at each instant in the cardiac cycle, thus making the LAA tip more prone to fluid stagnation, and therefore to thrombus formation. Velocity and SSR also decrease from normal to AF conditions. After four cardiac cycles, the lowest washout of contrast agent was observed for the Cauliflower morphology (3.27% of residual contrast in AF), and the highest for the Windsock (0.56% of residual contrast in AF). This suggests that the former is expected to be associated with a higher risk of thrombosis, in agreement with clinical reports in the literature. The presented computational models highlight the major role played by the LAA morphology on the hemodynamics, both in normal and AF conditions, revealing the potential support that numerical analyses can provide in the stratification of patients under risk of thrombus formation, towards personalised patient care.

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“…A comprehensive model of the atrium using a simplified idealized geometry was recently published by Zhang and Gay (2008) and was based on transesophageal echocardiography. Up to now, the only model of the atrium obtained from tomographic imaging was reported by Jernigan et al (2007) on an excised porcine left atrium, to facilitate the design of an endoscopic retractor.…”

Section: Discussionmentioning

confidence: 99%

In vivo porcine left atrial wall stress: Computational model

Martino

Bellini

Schwartzman

2011

Journal of Biomechanics

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Characterizing left atrial appendage functions in sinus rhythm and atrial fibrillation using computational models

Cited by 63 publications

References 44 publications

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Numerical studies of blood flow in healthy, stenosed, and stented carotid arteries

Computational Fluid Dynamic Analysis of the Left Atrial Appendage to Predict Thrombosis Risk

In vivo porcine left atrial wall stress: Computational model

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