Computational analysis of thrombosis risk in a patient with left ventricular assist device

Left ventricular assist device (LVAD) implantation has become an important treatment for heart failure patients. However, adverse events related to thrombosis remain severe problems after LVAD implantation. In this study, we propose a novel numerical framework to evaluate the impact of LVAD on hemodynamics and thrombosis risk on a patient-specific level. Potential locations of thrombosis are identified using several hemodynamic indicators related to wall shear stress and flow velocity. The implantation of LVAD leads to reduced washout in the left ventricle, enhanced recirculation in the aorta, large velocity gradients in the inflow cannula, and irregular velocity profiles in the outflow graft. As a consequence, thrombosis risk in three typical locations is increased, including the aortic root, the curved outflow graft, and the junction of the inflow cannula and the left ventricle. By increasing LVAD workload, the thrombosis risk at the junction of the inflow cannula and the left ventricle is reduced due to enhanced washout. However, the thrombosis risk at the aortic root and the curved outflow graft is increased, resulting from either enhanced recirculation or increased wall shear stress. These findings provide guidelines for surgical planning and postoperative management in clinical practice.