Pulsatile flow simulation of patent ductus arteriosus to evaluate thrombosis factors on closure device

Abstract

Transcatheter treatment using occlusion devices is the most common treatment used to treat the Patent Ductus Arteriosus (PDA). The occlusion device act as a physical barrier to blood flow in the duct which facilitates thrombogenesis and occludes the duct. Over the past 15 years, there have been significant developments in the devices used to close PDA. Various design of occlusion device affects the flow of blood in the duct. To improve the efficiency of the thrombogenesis on the surface of occlusion device and estimate the time needed to occludes the duct, it is important to simulate blood flow through different design of occlusion device. Two design was used which is the concave and convex shape of the occlusion device. Blood was simulated as Newtonian with the incompressible and laminar flow. A computational fluid dynamics (CFD) study has been done in pulsatile blood flow through the aortic arch and the occlusion device. The hemodynamic parameters that contribute to the thrombosis formation have been studied and showed that the convex shape yielded more TAWSS_low (< 0.5 Pa) magnitude (65.72%), generated 51.84% areas that exposed to high OSI and calculated 14.46% areas that exposed to RRT ≥ 10 Pa^-1. While, concave shape yielded 13.21% of TAWSS_low (< 0.5 Pa), generated only 47.84% of areas that exposed to high OSI and calculated 14.46% areas that exposed to RRT ≥ 10 Pa^-1. Therefore, from the preliminary work on PDA occlusion device, it is suggested that to promote thrombosis, the convex shape was much better compared to concave shape.