Sensitivity analysis of in silico fluid simulations to predict thrombus formation after left atrial appendage occlusion

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Mill, Jordi
• dc.contributor.author Agudelo, Victor
• dc.contributor.author Olivares Miyares, Andy Luis
• dc.contributor.author Pons Vidal, Maria Isabel
• dc.contributor.author Silva, Etelvino
• dc.contributor.author Nuñez-Garcia, Marta
• dc.contributor.author Morales Ferez, Xabier
• dc.contributor.author Arzamendi, Dabit
• dc.contributor.author Freixa, Xavier
• dc.contributor.author Noailly, Jérôme
• dc.contributor.author Camara, Oscar
• dc.date.accessioned 2022-06-28T06:13:02Z
• dc.date.available 2022-06-28T06:13:02Z
• dc.date.issued 2021
• dc.description.abstract Atrial fibrillation (AF) is nowadays the most common human arrhythmia and it is considered 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.
• dc.description.sponsorship This work was supported by the Spanish Ministry of Science, Innovation and Universities under the Retos I+D Programme (RTI2018-101193-B-I00), the Maria de Maeztu Units of Excellence Programme (MDM-2015-0502), the Spanish Ministry of Economy and Competitiveness under the Programme for the Formation of Doctors (PRE2018-084062), and MINECO (RYC-2015-18888). Additionally, this work was supported by the H2020 EU SimCardioTest project (Digital transformation in Health and Care SC1-DTH-06-2020; grant agreement No. 101016496).
• dc.format.mimetype application/pdf
• dc.identifier.citation Mill J, Agudelo V, Olivares AL, Pons MI, Silva E, Nuñez-Garcia M, Morales X, Arzamendi D, Freixa X, Noailly J, Camara O. Sensitivity analysis of in silico fluid simulations to predict thrombus formation after left atrial appendage occlusion. Mathematics. 2021;9:2304. DOI: 10.3390/math9182304
• dc.identifier.doi http://dx.doi.org/10.3390/math9182304
• dc.identifier.issn 2227-7390
• dc.identifier.uri http://hdl.handle.net/10230/53605
• dc.language.iso eng
• dc.publisher MDPI
• dc.relation.ispartof Mathematics. 2021;9:2304.
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/101016496
• dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/RYC-2015-18888
• dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RTI2018-101193-B-I00
• dc.rights © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword sensitivity analysis
• dc.subject.keyword boundary conditions
• dc.subject.keyword computational fluid dynamics
• dc.subject.keyword dynamic mesh
• dc.subject.keyword device-related thrombus
• dc.subject.keyword left atrium
• dc.subject.keyword left atrial appendage
• dc.title Sensitivity analysis of in silico fluid simulations to predict thrombus formation after left atrial appendage occlusion
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion