Computational Fluid Dynamic Simulation to Evaluate the Device-Related Effects After Left Atrial Appendage Occlusion
摘要
The left atrial appendage occlusion (LAAO) is a recommended treatment for atrial fibrillation (AF) patients unable to take anti-coagulation therapy. However, the occurrence of thromboembolic events after LAAO have an incidence up to 16%. In this study, computational fluid dynamics (CFD) was used to investigate the hemodynamic effects of different devices following LAAO. Patient-specific models before and after LAAO were obtained from computed tomography images. Patients with three different implanted devices were considered. CFD simulations were conducted in an AF scenario, using patient-specific inflow pressure condition at pulmonary veins and outflow velocity profile at mitral valve. Results were analysed in terms of pressure, velocity, and main hemodynamic indices. Significant differences were found for all parameters not only between pre- and post-LAAO but also among the different devices, thus demonstrating that a residual non-negligible risk of thrombus formation is still present.