Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders

ABSTRACT Introduction and objectives: Left atrial appendage occlusion (LAAO) can be an efficient treatment to prevent strokes in patients who suffer from atrial fibrillation, especially those at risk of bleeding. A non-negligible number of patients treated with LAAO develop device-related thrombosis...

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Autores principales:	Jordi Mill, Victor Agudelo, Chi Hion Li, Jerome Noailly, Xavier Freixa, Oscar Camara, Dabit Arzamendi
Formato:	article
Lenguaje:	EN ES
Publicado:	Permanyer 2021
Materias:	Device-related thrombosis Flow simulation Left atrial appendage occlusion Patient-specific Medicine R
Acceso en línea:	https://doaj.org/article/81b55de5e80046549cd1bcc99909b3d8
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spelling	oai:doaj.org-article:81b55de5e80046549cd1bcc99909b3d82021-11-16T10:20:34ZPatient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders10.24875/RECICE.M210002242604-7322https://doaj.org/article/81b55de5e80046549cd1bcc99909b3d82021-11-01T00:00:00Zhttps://recintervcardiol.org/en/index.php?option=com_content&view=article&id=690https://doaj.org/toc/2604-7322ABSTRACT Introduction and objectives: Left atrial appendage occlusion (LAAO) can be an efficient treatment to prevent strokes in patients who suffer from atrial fibrillation, especially those at risk of bleeding. A non-negligible number of patients treated with LAAO develop device-related thrombosis (DRT) after device implantation. Our study aimed to identify the key blood flow characteristics leading to DRT using patient-specific flow simulations. Methods: Patients treated with LAAO between 2014 and 2019 at a single center with preoperative and follow-up computerized tomography images and ultrasound imaging (US) were used to create patient-specific flow simulations. Amulet LAAO devices were implanted in the study patients. Flow simulations were blindly assessed to discard the presence of DRT in the follow-up imaging. Results: A total of 6 patients were processed in this pivotal study, half of them with DRT at the follow-up according to the imaging analysis. After a comprehensive analysis of the simulations, the most relevant in silico indices associated with DRT were the presence of stagnant blood flow, recirculation with low flow velocities (< 0.20 m/s) next to the device surface, and regions with high flow complexity combined with low wall shear stress. Conclusions: Patient-specific flow simulations of LAAO were successfully used to predict blood flow patterns with different device configurations. The results show the potential of the present modelling and simulation approach to recommend optimal settings capable of minimizing the risk of DRT.Jordi MillVictor AgudeloChi Hion LiJerome NoaillyXavier FreixaOscar CamaraDabit ArzamendiPermanyerarticleDevice-related thrombosis Flow simulation Left atrial appendage occlusion Patient-specificMedicineRENESREC: Interventional Cardiology (English Ed.), Vol 3, Iss 4, Pp 278-285 (2021)
institution	DOAJ
collection	DOAJ
language	EN ES
topic	Device-related thrombosis Flow simulation Left atrial appendage occlusion Patient-specific Medicine R
spellingShingle	Device-related thrombosis Flow simulation Left atrial appendage occlusion Patient-specific Medicine R Jordi Mill Victor Agudelo Chi Hion Li Jerome Noailly Xavier Freixa Oscar Camara Dabit Arzamendi Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
description	ABSTRACT Introduction and objectives: Left atrial appendage occlusion (LAAO) can be an efficient treatment to prevent strokes in patients who suffer from atrial fibrillation, especially those at risk of bleeding. A non-negligible number of patients treated with LAAO develop device-related thrombosis (DRT) after device implantation. Our study aimed to identify the key blood flow characteristics leading to DRT using patient-specific flow simulations. Methods: Patients treated with LAAO between 2014 and 2019 at a single center with preoperative and follow-up computerized tomography images and ultrasound imaging (US) were used to create patient-specific flow simulations. Amulet LAAO devices were implanted in the study patients. Flow simulations were blindly assessed to discard the presence of DRT in the follow-up imaging. Results: A total of 6 patients were processed in this pivotal study, half of them with DRT at the follow-up according to the imaging analysis. After a comprehensive analysis of the simulations, the most relevant in silico indices associated with DRT were the presence of stagnant blood flow, recirculation with low flow velocities (< 0.20 m/s) next to the device surface, and regions with high flow complexity combined with low wall shear stress. Conclusions: Patient-specific flow simulations of LAAO were successfully used to predict blood flow patterns with different device configurations. The results show the potential of the present modelling and simulation approach to recommend optimal settings capable of minimizing the risk of DRT.
format	article
author	Jordi Mill Victor Agudelo Chi Hion Li Jerome Noailly Xavier Freixa Oscar Camara Dabit Arzamendi
author_facet	Jordi Mill Victor Agudelo Chi Hion Li Jerome Noailly Xavier Freixa Oscar Camara Dabit Arzamendi
author_sort	Jordi Mill
title	Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
title_short	Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
title_full	Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
title_fullStr	Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
title_full_unstemmed	Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
title_sort	patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders
publisher	Permanyer
publishDate	2021
url	https://doaj.org/article/81b55de5e80046549cd1bcc99909b3d8
work_keys_str_mv	AT jordimill patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders AT victoragudelo patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders AT chihionli patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders AT jeromenoailly patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders AT xavierfreixa patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders AT oscarcamara patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders AT dabitarzamendi patientspecificflowsimulationanalysistopredictdevicerelatedthrombosisinleftatrialappendageoccluders
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Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders

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