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Morphotype-based risk stratification in patients with patent foramen ovale using computational fluid dynamics
Fabio Morelli1, Valeria Guadagno2, Tatiana Mencarini2
1Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy. fabio.morelli@polimi.it.
Scientific Reports
|October 3, 2025
Summary
Patent Foramen Ovale (PFO) linked to migraine with aura. Specific PFO shapes increase red blood cell stress via altered blood flow, suggesting a new risk assessment index.
Area of Science:
- Cardiovascular physiology
- Biomedical engineering
- Neurology
Background:
- Patent Foramen Ovale (PFO) affects ~25% of adults, linked to stroke and migraine with aura.
- Biomechanical mechanisms connecting PFO morphology, hemodynamics, and red blood cell (RBC) stress are poorly understood.
Purpose of the Study:
- To investigate how PFO tunnel geometry influences blood flow dynamics and RBC mechanical stress.
- To identify specific PFO morphologies associated with increased pathological stress.
Main Methods:
- Utilized computational fluid dynamics (CFD) and Lagrangian particle tracking.
- Simulated blood flow and RBC stress across eight distinct PFO morphologies under Valsalva conditions.
Main Results:
- Elongated/narrow PFOs showed jet-like flows, higher wall shear stress (WSS), and significantly increased RBC stress.
- The length-to-diameter ratio ([Formula: see text]) predicted mechanical exposure; outlet diameter related to desaturation.
Conclusions:
- PFO geometry directly impacts hemodynamics and RBC stress, providing a mechanistic link to clinical risks.
- The [Formula: see text] ratio is a potential index for stratifying PFO-related clinical risk via imaging.
