Back We are pleased to inform that PhySense has a new Doctor!! Dr. Jordi Mill
We are pleased to inform that PhySense has a new Doctor!! Dr. Jordi Mill
Congratulations to Dr. Mill Tena, who has been awarded with the Mention "Cum Laude". Well done!!
Dr. Mill presented his dissertation on October 14th, 2022.
Dr. Oscar Camara, Dr. Jérôme Noailly and Dr. Andy L. Olivares (Universitat Pompeu Fabra, Barcelona, Spain)
Computational fluid simulations in clinical datasets for understanding thrombus formation before and after left atrial appendage occlusion
Atrial fibrillation is considered the most common arrhythmia in humans. Because the left atrium of the heart stops beating properly and begins to do so in an arrhythmic manner, the blood may become stagnant in a small cavity attached to the left atrium called the left atrium. If this happens, a thrombus forms in this cavity which can lead to an stroke. One of the possible treatments, especially if the patient has contraindications to anticoagulants is the closure of the left atrial appendage with a device introduced non-invasively. However, the reason why some shapes of left atrial appendages form a thrombus or not, or why after the
intervention some patients form them on the device surface is not entirely clear. Blood velocity is known to be one of the most important factors in the process of thrombogenesis, but current imaging techniques do not have enough resolution to assess flow so locally. For this reason flow simulations based on computational fluid dynamics and numerical methods, already used in other sectors of the industry (e.g. aeronautics or automotive), could be used to predict which patients will form thrombus or not in a personalized manner. The thesis below aims to help clarify the role of flow in the thrombus formation process in patients with atrial fibrillation using computational fluid dynamics simulations personalized to each patient. To do this, the thesis is divided into three main contributions. First, a sensitivity analysis to test all the approaches published so far and new methods developed during the course of this thesis. Second, it will be shown how pulmonary veins, an understudied factor, have a key role in the hemodynamics of flow within the left atrium and therefore in thrombus formation along with other cavity morphological factors using the largest simulated cohort of patients to this date. Finally, it will be shown how the position of the device is key when creating local flow re-circulations at low velocities which can then activate the coagulation process forming a thrombus.