Related Experiment Video
Updated: Aug 21, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
An integrated fluid-dynamic and structural pipeline to assess atrial hemodynamics before and after left atrial
Benigno Marco Fanni1, Francesca Danielli2, Chiara Bonfanti1,3
1BioCardioLab, Bioengineering Unit, Fondazione Monasterio, Massa, 54100, Italy.
Insights
This study introduces a computational workflow to assess left atrial appendage occlusion (LAAO) device placement and blood clot risk. It analyzes how patient anatomy and device fit impact outcomes for atrial fibrillation patients.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Computational Science
Background:
- Atrial fibrillation (AF) carries a high risk of thromboembolic events.
- Left atrial appendage occlusion (LAAO) is an alternative to anticoagulation for stroke prevention in AF patients.
- Understanding biomechanical and hemodynamic factors is crucial for optimizing LAAO success.
Purpose of the Study:
- To develop and validate a patient-informed computational workflow for assessing LAAO device deployment.
- To investigate the influence of atrial wall stiffness on device placement and post-operative hemodynamics.
- To evaluate the impact of different fabric reconstruction strategies on hemodynamic outcomes.
Main Methods:
- Integration of pre-operative computational fluid dynamics (CFD) and finite element (FE) modeling.
- FE analysis of LAAO device deployment considering varying atrial wall stiffness.
- Post-operative CFD simulations incorporating FE-deformed configurations and fabric models.
Main Results:
- Pre-implant CFD identified thrombotic risk regions in the left atrial appendage.
- FE simulations showed atrial stiffness affects device positioning and interaction with anatomy.
- Post-implant CFD revealed flow redirection and altered wall shear stress due to device configuration and fabric variability.
Conclusions:
- The proposed multiphysics workflow enables comprehensive assessment of mechanical and hemodynamic outcomes for LAAO.
- Anatomical and biomechanical factors significantly influence post-operative left atrial hemodynamics.
- This approach advances patient-specific computational frameworks for LAAO device deployment and thrombogenic risk evaluation.
Abstract:
Atrial fibrillation is associated with a high risk of thromboembolic events, often mitigated by left atrial appendage occlusion (LAAO) when anticoagulation is contraindicated. This study presents a patient-informed computational workflow integrating pre-operative computational fluid dynamics (CFD), finite element (FE) modeling of device deployment, and post-operative CFD informed by the FE-deformed configuration. A proof-of-concept case was analyzed considering three atrial wall stiffness values to explore biomechanical variability. Pre-implant CFD simulations identified regions of blood stasis within the left atrial appendage, highlighting areas of thrombotic risk. FE simulations of device deployment demonstrated that wall stiffness influenced device positioning, orientation, and contact with the atrial anatomy. Post-implant CFD analyses, incorporating both the FE-informed device configuration and two fabric reconstruction strategies (conformal vs. detached), revealed flow redirection and changes in wall shear stress consistent with effective occlusion and the impact of fabric variability. Overall, the proposed workflow enabled a coherent assessment of mechanical and hemodynamic outcomes, providing insights into how anatomical and biomechanical factors affect post-operative LA hemodynamics. This multiphysics approach offers a step toward a patient-informed computational framework for assessing device deployment and thrombogenic risk under complete occlusion conditions.
