King's College London

Research portal

Left Atrial Appendage Morphology Impacts Thrombus Formation Risks in Multi-Physics Atrial Models

Research output: Chapter in Book/Report/Conference proceedingConference paperpeer-review

Ahmed Qureshi, Maximilian Balmus, Dmitry Nechipurenko, Fazoil Ataullakhanov, Steven Williams, Gregory Lip, David Nordsletten, Oleg Aslanidi, Adelaide De Vecchi

Original languageEnglish
Title of host publication2021 Computing in Cardiology, CinC 2021
PublisherIEEE Computer Society
ISBN (Electronic)9781665479165
DOIs
Published2021
Event2021 Computing in Cardiology, CinC 2021 - Brno, Czech Republic
Duration: 13 Sep 202115 Sep 2021

Publication series

NameComputing in Cardiology
Volume2021-September
ISSN (Print)2325-8861
ISSN (Electronic)2325-887X

Conference

Conference2021 Computing in Cardiology, CinC 2021
Country/TerritoryCzech Republic
CityBrno
Period13/09/202115/09/2021

Bibliographical note

Funding Information: This research was supported by the EPSRC [EP/R513064/1]. Publisher Copyright: © 2021 Creative Commons.

King's Authors

Abstract

Atrial fibrillation (AF) is a major cause of stroke and there has been much interest in the underlying mechanisms leading to this higher risk of thrombus formation. The latter risk correlates with four morphologies of the left atrial appendage (LAA), i.e. chicken wing (CW), broccoli (BR), cactus (CA) and windsock (WS). We present a mechanistic study of coagulation dynamics in blood flow in a series of 2D models of the left atrium (LA) to dissect the impact of LAA shape on thrombus formation. Interactions between blood flow, viscosity and key clotting proteins (thrombin, fibrinogen and fibrin) were modelled during 1 minute of pulsatile LA blood flow to simulate the blood gelification process leading to thrombus formation. Simulations were performed in sinus rhythm (SR) and AF by varying the active contraction of the LAA and pulmonary vein inflow velocities. In the CW morphology, fibrin inside the LAA was almost completely washed out after 28 seconds in SR, while in AF the gelification process was slow, suggesting the CW has the lowest risk of thrombus formation. Conversely, the BR morphology had the highest risk of thrombus formation due to a region of sustained flow stasis which prevented fibrin washout during SR and facilitated the shortest time to thrombus formation in AF.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454