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García-Isla G, Olivares AL, Silva E, Nuñez-Garcia M, Butakoff C, Sanchez-Quintana D, G Morales H, Freixa X, Noailly J, De Potter T, Camara O. Sensitivity analysis of geometrical parameters to study haemodynamics and thrombus formation in the left atrial appendage. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2018; 34:e3100. [PMID: 29737037 DOI: 10.1002/cnm.3100] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/02/2018] [Accepted: 04/15/2018] [Indexed: 06/08/2023]
Abstract
The left atrial appendage (LAA) is a complex and heterogeneous protruding structure of the left atrium (LA). In atrial fibrillation patients, it is the location where 90% of the thrombi are formed. However, the role of the LAA in thrombus formation is not fully known yet. The main goal of this work is to perform a sensitivity analysis to identify the most relevant LA and LAA morphological parameters in atrial blood flow dynamics. Simulations were run on synthetic ellipsoidal left atria models where different parameters were individually studied: pulmonary veins and mitral valve dimensions; LAA shape; and LA volume. Our computational analysis confirmed the relation between large LAA ostia, low blood flow velocities and thrombus formation. Additionally, we found that pulmonary vein configuration exerted a critical influence on LAA blood flow patterns. These findings contribute to a better understanding of the LAA and to support clinical decisions for atrial fibrillation patients.
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Affiliation(s)
- Guadalupe García-Isla
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Andy Luis Olivares
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Etelvino Silva
- Arrhythmia Unit, Department of Cardiology, Cardiovascular Center, Aalst, Belgium
| | - Marta Nuñez-Garcia
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Constantine Butakoff
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Hernán G Morales
- Medisys, Philips Research, Paris, France
- Centro de Fisiologia del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago de Chile, Chile
| | - Xavier Freixa
- Department of Cardiology, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Jérôme Noailly
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Tom De Potter
- Arrhythmia Unit, Department of Cardiology, Cardiovascular Center, Aalst, Belgium
| | - Oscar Camara
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
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