2026-06-02T11:04:44Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/270722026-02-03T11:15:45Zcom_10630_2254col_10630_37953

00925njm 22002777a 4500 dc Durán Venegas, Eduardo author García-Villalba, Manuel author Martínez-Legazpi, Pablo author Gonzalo, Alejandro author McVeigh, Elliot author Kahn, Andrew M. author Bermejo, Javier author Flores, Óscar author Del Álamo, Juan Carlos author 2023 Disruptions to left atrial (LA) blood flow, such as those caused by atrial fibrillation (AF), can lead to thrombosis in the left atrial appendage (LAA) and an increased risk of systemic embolism. LA hemodynamics are influenced by various factors, including LA anatomy and function, and pulmonary vein (PV) inflow conditions. In particular, the PV flow split can vary significantly among and within patients depending on multiple factors. In this study, we investigated how changes in PV flow split affect LA flow transport, focusing for the first time on blood stasis in the LAA, using a high-fidelity patient-specific computational fluid dynamics (CFD) model. We use an Immersed Boundary Method, simulating the flow in a fixed, uniform Cartesian mesh and imposing the movement of the LA walls with a moving Lagrangian mesh generated from 4D Computerized Tomography images. We analyzed LA anatomies from eight patients with varying atrial function, including three with AF and either a LAA thrombus or a history of Transient Ischemic Attacks (TIAs). Using four different flow splits (60/40% and 55/45% through right and left PVs, even flow rate, and same velocity through each PV), we found that flow patterns are sensitive to PV flow split variations, particularly in planes parallel to the mitral valve. Changes in PV flow split also had a significant impact on blood stasis and could contribute to increased risk for thrombosis inside the LAA, particularly in patients with AF and previous LAA thrombus or a history of TIAs. Our study highlights the importance of considering patient-specific PV flow split variations when assessing LA hemodynamics and identifying patients at increased risk for thrombosis and stroke. This knowledge is relevant to planning clinical procedures such as AF ablation or the implementation of LAA occluders. Eduardo Durán, Manuel García-Villalba, Pablo Martínez-Legazpi, Alejandro Gonzalo, Elliot McVeigh, Andrew M. Kahn, Javier Bermejo, Oscar Flores, Juan Carlos del Álamo, Pulmonary vein flow split effects in patient-specific simulations of left atrial flow, Computers in Biology and Medicine, Volume 163, 2023, 107128, ISSN 0010-4825, https://doi.org/10.1016/j.compbiomed.2023.107128. https://hdl.handle.net/10630/27072 10.1016/j.compbiomed.2023.107128 Hemodinámica Flujo sanguíneo Pulmonary vein flow split effects in patient-specific simulations of left atrial flow