In-silico analysis of device-related thrombosis for different left atrial appendage occluder settings
In-silico analysis of device-related thrombosis for different left atrial appendage occluder settings
Citació
- Planas E, Mill J, Olivares AL, Morales X, Pons MI, Iriart X, Cochet H, Camara O. In-silico analysis of device-related thrombosis for different left atrial appendage occluder settings. In: Puyol Antón E, Pop M, Martín-Isla C, Sermesant M, Suinesiaputra A, Camara O, Lekadir K, Young A, editors. Statistical Atlases and Computational Models of the Heart. Multi-Disease, Multi-View, and Multi-Center Right Ventricular Segmentation in Cardiac MRI Challenge. 12th International Workshop, STACOM 2021, Held in Conjunction with MICCAI 2021; 2021 Sep 27; Strasbourg, France. London: Springer; 2021. p. 160–8. (LNCS; volume 13131). DOI: 10.1007/978-3-030-9372
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Descripció
Resum
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and is associated to an increasing risk of stroke. Most AF- related strokes are formed in the left atrial appendage (LAA). To prevent thrombus formation, LAA occlusion (LAAO) is considered a suitable alternative for AF patients with contraindications for anti-coagulation treatment. Nevertheless, LAAO is linked to a non-negligible risk of gener- ating thrombus at the surface near the device (i.e., device-related throm- bus, DRT), depending on the implantation settings. For instance, it has been shown that not covering the pulmonary ridge (PR) with the LAAO increases the risk of DRT. In-silico analysis is a useful tool to better understand the blood flow patterns after LAAO and predict the risk of DRT for a given patient and device configuration. In the present work we designed a modelling pipeline based on fluid simulations, including a thrombus model using discrete phase modelling, to analyse the risk of DRT in six patient-specific geometries for different LAAO settings. In particular, we studied the possible incidence of DRT depending on the device positioning (covering/uncovering the PR) and type (Amplatzer Amulet and Watchman FLX). The resulting in-silico indices demon- strated that covering the PR entails less thrombogenic patterns than uncovering it. In our study, disk-based devices had better adaptability to complex LAA morphologies and a slightly minor associated risk of DRT than non-disk devices.Descripció
Comunicació presentada a: 12th International Workshop, STACOM 2021 celebrada del 27 de setembre de 2021 a Strasbourg, França.