A novel validated computational pipeline for patient specific deployment of the Amulet Amplatzer in the left atrial appendage
Please login to view abstract download link
Introduction The left atrial appendage (LAA), a protrusion of the left atrium, is the main thrombus source causing stroke in atrial fibrillation patients (1). Percutaneous LAA occlusion (LAAO) with devices like Amulet Amplatzer is a growing treatment. Complications, like peri-device leakage from malposition, are not uncommon (2). This study computationally simulates LAAO in virtual LAAs using Finite Element (FE) models, validated against clinical post-operative data. Methods Patient-specific CT images from University College London Hospital underwent semi-automatic segmentation with Mimics to reconstruct pre- and post-LAAO 3D heart anatomy. The Amulet Amplatzer device was CAD-designed in Rhinoceros both as an approximate homogenised shell model and a more accurate braided structure. FE simulations were run in Abaqus, modelling Nitinol behavior and sliding contact. The crimped device, initially in its delivery sheath, was released into the pre-implantation anatomy. Results & Discussion LAAO apposition onto the LAA ostium and neck was quantitatively evaluated considering gap areas and contact pressure. The simulated configurations of both shell and wired devices were validated against post-LAAO clinical 3D images. Conclusion This study shows how validated patient-specific virtual models could aid clinical decision-making, supporting patient selection and minimizing peri-device leakage and stroke risks. REFERENCES [1] G. Musotto et al. The Role of Patient-Specific Morphological Features of the Left Atrial Appendage on the Thromboembolic Risk Under Atrial Fibrillation. Front Cardiovasc Med. 2022 Jul 14;9. [2] A.M. Bavo et al. Validation of a computational model aiming to optimize preprocedural planning in percutaneous left atrial appendage closure. J Cardiovasc Comput Tomogr. 2020 Mar;14(2):149–54.
