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Computational fluid dynamics (CFD) models of blood flow in the left ventricle(LV) and aorta are important tools for analyzing the mechanistic links betweenmyocardial deformation and flow patterns. Typically, the use of image-basedkinematic CFD models prevails in applications such as predicting the acuteresponse to interventions which alter LV afterload conditions. However, suchmodels are limited in their ability to analyze any impacts upon LV load or keybiomarkers known to be implicated in driving remodeling processes as LVfunction is not accounted for in a mechanistic sense.  This study addresses these limitations by reporting on progress made towardsa novel electro-mechano-fluidic (EMF) model that represents the entire physicsof LV electromechanics (EM) based on first principles. A biophysically detailedfinite element (FE) model of LV EM was coupled with a FE-based CFD solver formoving domains using an arbitrary Eulerian-Lagrangian (ALE) formulation. Twoclinical cases of patients suffering from aortic coarctations (CoA) were builtand parameterized based on clinical data under pre-treatment conditions. Forone patient case simulations under post-treatment conditions after geometricrepair of CoA by a virtual stenting procedure were compared againstpre-treatment results. Numerical stability of the approach was demonstrated byanalyzing mesh quality and solver performance under the significantly largedeformations of the LV blood pool. Further, computational tractability andcompatibility with clinical time scales were investigated by performing strongscaling benchmarks up to 1536 compute cores. The overall cost of the entireworkflow for building, fitting and executing EMF simulations was comparable tothose reported for image-based kinematic models, suggesting that EMF modelsshow potential of evolving into a viable clinical research tool.

Towards a Computational Framework for Modeling the Impact of Aortic Coarctations upon Left Ventricular Load