Atrial fibrillation (AF) is considered the most common human arrhythmia. Around 99% of thrombi in non-valvular AF are formed
in the left atrial appendage (LAA). Studies suggest that abnormal LAA
haemodynamics and the subsequently stagnated flow are the factors triggering clot formation. However, the relation between LAA morphology,
the blood pattern and the triggering is not fully understood. Moreover,
the impact of structures such as the pulmonary veins (PVs) on LA
haemodynamics has not been ...
Atrial fibrillation (AF) is considered the most common human arrhythmia. Around 99% of thrombi in non-valvular AF are formed
in the left atrial appendage (LAA). Studies suggest that abnormal LAA
haemodynamics and the subsequently stagnated flow are the factors triggering clot formation. However, the relation between LAA morphology,
the blood pattern and the triggering is not fully understood. Moreover,
the impact of structures such as the pulmonary veins (PVs) on LA
haemodynamics has not been thoroughly studied due to the difficulties of
acquiring appropriate data. On the other hand, in-silico studies and flow
simulations allow a thorough analysis of haemodynamics, analysing the
4D nature of blood flow patterns under different boundary conditions.
However, the reduced number of cases reported on the literature of these
studies has been a limitation. The main goal of this work was to study the
influence of PVs on left atrium (LA) and LAA haemodynamics. Computational fluid dynamics simulations were run on 52 patients, the largest
cohort so far in the literature, where different parameters were individually studied: pulmonary veins orientation and configuration; LAA and
LA volumes and its ratio; and flow velocities. Our computational analysis showed how the right pulmonary vein height and angulation have a
great influence on LA haemodynamics. Additionally, we found that LAA
with great bending with its tip pointing towards the mitral valve could
contribute to favour flow stagnation.
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