论文标题

用于亚临床小叶血栓形成应用的流体结构和生化相互作用模型

A Model of Fluid-Structure and Biochemical Interactions for Applications to Subclinical Leaflet Thrombosis

论文作者

Barrett, Aaron, Brown, Jordan A., Smith, Margaret Anne, Woodward, Andrew, Vavalle, John P., Kheradvar, Arash, Griffith, Boyce E., Fogelson, Aaron L.

论文摘要

亚临床小叶血栓形成(SLT)是主动脉瓣替代的潜在严重并发症,用生物假体瓣膜置换,其中替代阀上形成了血凝块。 SLT与瞬时缺血性发作和中风的风险增加有关,并且可以发展为临床传单血栓形成。主动脉瓣置换后的SLT也可能与随后的结构瓣膜变质有关,这可能会损害瓣膜更换的耐用性。由于SLT临床成像的困难,需要模型来确定SLT的机制,并最终可以预测哪些患者会出现SLT。为此,我们开发了模拟小叶血栓形成的方法,这些方法结合了流体结构相互作用和简化的血栓形成模型,该模型允许沿着移动的小叶进行沉积。此外,该模型可以适应沿其他移动边界的模型沉积或吸收。我们提出收敛结果,并量化模型实现阀门打开和压力变化的能力。这些新方法是我们建模血栓形成的工具中的重要进步,在该工具中,它们既将其粘附到运动小叶表面,又融合了对流体结构相互作用的反馈。

Subclinical leaflet thrombosis (SLT) is a potentially serious complication of aortic valve replacement with a bioprosthetic valve in which blood clots form on the replacement valve. SLT is associated with increased risk of transient ischemic attacks and strokes and can progress to clinical leaflet thrombosis. SLT following aortic valve replacement also may be related to subsequent structural valve deterioration, which can impair the durability of the valve replacement. Because of the difficulty in clinical imaging of SLT, models are needed to determine the mechanisms of SLT and could eventually predict which patients will develop SLT. To this end, we develop methods to simulate leaflet thrombosis that combine fluid-structure interaction and a simplified thrombosis model that allows for deposition along the moving leaflets. Additionally, this model can be adapted to model deposition or absorption along other moving boundaries. We present convergence results and quantify the model's ability to realize changes in valve opening and pressures. These new approaches are an important advancement in our tools for modeling thrombosis in which they incorporate both adhesion to the surface of the moving leaflets and feedback to the fluid-structure interaction.

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