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Cardiac disease and clinical intervention may both lead to an increased riskfor thrombosis events due to modified blood flow in the heart, and thereby achange in the mechanical stimuli of blood cells passing through the chambers ofthe heart. Specifically, the degree of platelet activation is influenced by thelevel and type of mechanical stresses in the blood flow. Here we analyze theblood flow in the left ventricle of the heart through a computational modelconstructed from patient-specific data. The blood flow in the ventricle ismodeled by the Navier-Stokes equations, and the flow through the mitral valveby a parameterized model which represents the projected opening of the valve. Afinite element method is used to solve the equations, from which a simulationof the velocity and pressure of the blood flow is constructed. A tripledecomposition of the velocity gradient tensor is then used to distinguishbetween rigid body rotational flow, irrotational straining flow, and shearflow. The triple decomposition enables the separation of three fundamentallydifferent flow structures, each generating a distinct type of mechanicalstimulus on the blood cells in the flow. We compare the results to simulationswhere a mitral valve clip intervention is modelled, which leads to asignificant modification of the ventricular flow. It was found that the shearin the simulation cases treated with clips increased more compared to theuntreated case than the rotation and strain did. A decrease in valve openingarea of 64 % in one of the cases led to a 90 % increase in rotation and strain,but a 150 % increase in shear. The computational analysis suggests a processfor patient-specific simulation of clinical interventions in the heart with adetailed analysis of the resulting blood flow, which could support clinicalrisk assessment with respect to platelet activation and thrombosis events.

Computational analysis of flow structures in turbulent ventricular blood flow associated with mitral valve intervention