ArticleJACC. Advances2024
Flow Dynamic Factors Correlated With Device-Related Thrombosis After Left Atrial Appendage Occlusion.
Article in JACC. Advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Beyond CHAAnnals of biomedical engineering · 2026Article
- An integrated fluid-dynamic and structural pipeline to assess atrial hemodynamics before and after left atrial appendage occluder deployment in a patient-specific anatomy.Medical & biological engineering & computing · 2026Article
- Disentangling the Hemodynamic Effects of A-Wave Loss and Cardiac Output Reduction in Atrial Fibrillation.Annals of biomedical engineering · 2026Article
- Virtual left atrial appendage occlusion in paroxysmal atrial fibrillation during sinus rhythm predicts variable reductions in blood stasis.The Journal of physiology · 2026Article
- Imaging-defined residual risk after left atrial appendage occlusion: from device surveillance to antithrombotic and reintervention decision considerations.Frontiers in cardiovascular medicine · 2026Review
- Atrial Cardiomyopathy: A "Distinct Clinical Entity" for a Deeper Understanding of Atrial Fibrillation and Cardioembolic Stroke.Journal of clinical medicine · 2025Review
- Design and Validation of a High-Fidelity Left Atrial Cardiac Simulator for the Study and Advancement of Left Atrial Appendage Occlusion.Cardiovascular engineering and technology · 2025Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Device-related thrombosis (DRT) occurs in up to 4% of patients undergoing left atrial appendage occlusion (LAAO) and is associated with substantial morbidity and mortality. However, its pathophysiology, predictors, and optimal management remain unclear. Objectives: This study aims to assess flow dynamic factors correlating to DRT. Methods: A multicenter registry of patients who underwent LAAO and had pre- and post-computed tomography imaging was used. Patient-specific 3-dimensional digital models of the left atrium were created, and finite element simulations were performed to implant an LAAO device into each model in a position that matched the clinical deployment. Computational fluid dynamic simulations were performed to quantify the following flow dynamic parameters: time averaged wall shear stress, oscillatory shear index, and endothelial cell activation potential. Results: A total of 38 patients (19 with DRT and 19 without DRT) were included. Left atrium volumes and mitral valve areas were larger in the DRT cohort compared with controls. Patients with DRT had a significantly lower time averaged wall shear stress (1.76 ± 1.24 Pa vs 2.90 ± 2.70 Pa), a higher oscillatory shear index (0.19 ± 0.11 vs 0.17 ± 0.11), and a higher endothelial cell activation potential (0.23 ± 0.58 Pa Conclusions: Flow dynamic parameters may be able to predict the risk of DRT after LAAO. Further investigation with a larger patient cohort and long-term follow-up is needed to assess the role of computational fluid dynamics in the risk stratification of patients considered for LAAO.
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