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Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy
In atrial fibrillation (AF), thromboembolic events can result from the particular conformation of the left atrial appendage (LAA) bearing increased clot formation and accumulation. Current therapies to reduce the risk of adverse events rely on surgical exclusion or percutaneous occlusion, each of wh...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225454/ https://www.ncbi.nlm.nih.gov/pubmed/35743668 http://dx.doi.org/10.3390/jpm12060883 |
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author | Pasta, Salvatore Guccione, Julius M. Kassab, Ghassan S. |
author_facet | Pasta, Salvatore Guccione, Julius M. Kassab, Ghassan S. |
author_sort | Pasta, Salvatore |
collection | PubMed |
description | In atrial fibrillation (AF), thromboembolic events can result from the particular conformation of the left atrial appendage (LAA) bearing increased clot formation and accumulation. Current therapies to reduce the risk of adverse events rely on surgical exclusion or percutaneous occlusion, each of which has drawbacks limiting application and efficacy. We sought to quantify the hemodynamic and structural loads of a novel potential procedure to partially invert the “dead” LAA space to eliminate the auricle apex where clots develop. A realistic left atrial geometry was first achieved from the heart anatomy of the Living Heart Human Model (LHHM) and then the left atrial appendage inversion (LAAI) was simulated by finite-element analysis. The LAAI procedure was simulated by pulling the elements at the LAA tip and prescribing a displacement motion along a predefined path. The deformed configuration was then used to develop a computational flow analysis of LAAI. Results demonstrated that the inverted LAA wall undergoes a change in the stress distribution from tensile to compressive in the inverted appendage, and this can lead to resorption of the LAA tissue as per a reduced stress/resorption relationship. Computational flow analyses highlighted a slightly nested low-flow velocity pattern for the inverted LAA with minimal differences from that of a model without inversion of the LAA apex. Our study revealed important insights into the biomechanics of LAAI and demonstrated the inversion of the stress field (from tensile to compressive), which &can ultimately lead the long-term resorption of the LAA. |
format | Online Article Text |
id | pubmed-9225454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92254542022-06-24 Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy Pasta, Salvatore Guccione, Julius M. Kassab, Ghassan S. J Pers Med Article In atrial fibrillation (AF), thromboembolic events can result from the particular conformation of the left atrial appendage (LAA) bearing increased clot formation and accumulation. Current therapies to reduce the risk of adverse events rely on surgical exclusion or percutaneous occlusion, each of which has drawbacks limiting application and efficacy. We sought to quantify the hemodynamic and structural loads of a novel potential procedure to partially invert the “dead” LAA space to eliminate the auricle apex where clots develop. A realistic left atrial geometry was first achieved from the heart anatomy of the Living Heart Human Model (LHHM) and then the left atrial appendage inversion (LAAI) was simulated by finite-element analysis. The LAAI procedure was simulated by pulling the elements at the LAA tip and prescribing a displacement motion along a predefined path. The deformed configuration was then used to develop a computational flow analysis of LAAI. Results demonstrated that the inverted LAA wall undergoes a change in the stress distribution from tensile to compressive in the inverted appendage, and this can lead to resorption of the LAA tissue as per a reduced stress/resorption relationship. Computational flow analyses highlighted a slightly nested low-flow velocity pattern for the inverted LAA with minimal differences from that of a model without inversion of the LAA apex. Our study revealed important insights into the biomechanics of LAAI and demonstrated the inversion of the stress field (from tensile to compressive), which &can ultimately lead the long-term resorption of the LAA. MDPI 2022-05-27 /pmc/articles/PMC9225454/ /pubmed/35743668 http://dx.doi.org/10.3390/jpm12060883 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Pasta, Salvatore Guccione, Julius M. Kassab, Ghassan S. Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy |
title | Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy |
title_full | Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy |
title_fullStr | Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy |
title_full_unstemmed | Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy |
title_short | Inversion of Left Atrial Appendage Will Cause Compressive Stresses in the Tissue: Simulation Study of Potential Therapy |
title_sort | inversion of left atrial appendage will cause compressive stresses in the tissue: simulation study of potential therapy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225454/ https://www.ncbi.nlm.nih.gov/pubmed/35743668 http://dx.doi.org/10.3390/jpm12060883 |
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