Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device
Abstract Left Ventricular Assist Devices (LVADs) are a key treatment option for patients with advanced heart failure, but they carry a significant risk of thromboembolic complications. While improved LVAD design, and systemic anticoagulation regimen, have helped mitigate thromboembolic risks, ischem...
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2025-04-01
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| author | Sreeparna Majee Akshita Sahni Jay D. Pal Erin E. McIntyre Debanjan Mukherjee |
| author_facet | Sreeparna Majee Akshita Sahni Jay D. Pal Erin E. McIntyre Debanjan Mukherjee |
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| description | Abstract Left Ventricular Assist Devices (LVADs) are a key treatment option for patients with advanced heart failure, but they carry a significant risk of thromboembolic complications. While improved LVAD design, and systemic anticoagulation regimen, have helped mitigate thromboembolic risks, ischemic stroke due to adverse thromboembolic events remains a major concern with current LVAD therapies. Improved understanding of embolic events, and embolus movement to the brain, is critical to develop techniques to minimize risks of occlusive embolic events such as a stroke after LVAD implantation. Here, we address this need, and devise a quantitative in silico framework to characterize thromboembolus transport and distrbution in hemodynamics driven by an operating LVAD. We conduct systematic numerical experiments to establish that our framework can quantify the source-to-destination transport patterns of thromboemboli as a function of: LVAD outflow graft anastomosis, LVAD operating pulse modulation, thromboembolus sizes, and origin locations of emboli. Additionally, we demonstrate how the resulting embolus distribution patterns compare and correlate with descriptors based solely on hemodynamic patterns such as helicity, vorticity, and wall shear stress. Using the concepts of size-dependent embolus-hemodynamics interactions, and jet impingement driven flow for hemodynamics under LVAD operation as established in our prior works, we gain valuable insights on departure of thromboembolus distribution from flow distribution, and establish that our in silico model can generate deep insights into embolus dynamics which is not otherwise available from standard of care imaging and clinical data. |
| format | Article |
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| institution | OA Journals |
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| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-650b68aae5f648cfaa2370eae58d50dd2025-08-20T02:11:41ZengNature PortfolioScientific Reports2045-23222025-04-0115111710.1038/s41598-025-88653-6Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist deviceSreeparna Majee0Akshita Sahni1Jay D. Pal2Erin E. McIntyre3Debanjan Mukherjee4Paul M Rady Department of Mechanical Engineering, University of Colorado BoulderPaul M Rady Department of Mechanical Engineering, University of Colorado BoulderDepartment of Surgery, University of Washington SeattleDivision of Cardiothoracic Surgery, University of ColoradoPaul M Rady Department of Mechanical Engineering, University of Colorado BoulderAbstract Left Ventricular Assist Devices (LVADs) are a key treatment option for patients with advanced heart failure, but they carry a significant risk of thromboembolic complications. While improved LVAD design, and systemic anticoagulation regimen, have helped mitigate thromboembolic risks, ischemic stroke due to adverse thromboembolic events remains a major concern with current LVAD therapies. Improved understanding of embolic events, and embolus movement to the brain, is critical to develop techniques to minimize risks of occlusive embolic events such as a stroke after LVAD implantation. Here, we address this need, and devise a quantitative in silico framework to characterize thromboembolus transport and distrbution in hemodynamics driven by an operating LVAD. We conduct systematic numerical experiments to establish that our framework can quantify the source-to-destination transport patterns of thromboemboli as a function of: LVAD outflow graft anastomosis, LVAD operating pulse modulation, thromboembolus sizes, and origin locations of emboli. Additionally, we demonstrate how the resulting embolus distribution patterns compare and correlate with descriptors based solely on hemodynamic patterns such as helicity, vorticity, and wall shear stress. Using the concepts of size-dependent embolus-hemodynamics interactions, and jet impingement driven flow for hemodynamics under LVAD operation as established in our prior works, we gain valuable insights on departure of thromboembolus distribution from flow distribution, and establish that our in silico model can generate deep insights into embolus dynamics which is not otherwise available from standard of care imaging and clinical data.https://doi.org/10.1038/s41598-025-88653-6Left Ventricular Assist DeviceHeart FailureStrokeEmbolismHemodynamics |
| spellingShingle | Sreeparna Majee Akshita Sahni Jay D. Pal Erin E. McIntyre Debanjan Mukherjee Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device Scientific Reports Left Ventricular Assist Device Heart Failure Stroke Embolism Hemodynamics |
| title | Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device |
| title_full | Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device |
| title_fullStr | Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device |
| title_full_unstemmed | Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device |
| title_short | Understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device |
| title_sort | understanding embolus transport and source to destination mapping of thromboemboli in hemodynamics driven by left ventricular assist device |
| topic | Left Ventricular Assist Device Heart Failure Stroke Embolism Hemodynamics |
| url | https://doi.org/10.1038/s41598-025-88653-6 |
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