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In the current work, we present a descriptive fluid-structure interaction computational study of the end-to-side radio-cephalic arteriovenous fistula. This allows us to account for the different thicknesses and elastic properties of the radial artery and cephalic vein. The core of the work consists in simulating different arteriovenous fistula configurations obtained by virtually varying the anastomosis angle, i.e. the angle between the end of the cephalic vein and the side of the radial artery. Since the aim of the work is to understand the blood dynamics in the very first days after the surgical intervention, the radial artery is considered stiffer and thicker than the cephalic vein. Our results demonstrate that both the diameter of the cephalic vein and the anastomosis angle play a crucial role to obtain a blood dynamics without re-circulation regions that could prevent fistula failure. When an anastomosis angle close to the perpendicular direction with respect to the radial artery is combined with a large diameter of the cephalic vein, the recirculation regions and the low Wall Shear Stress (WSS) zones are reduced. Conversely, from a structural point of view, a low anastomosis angle with a large diameter of the cephalic vein reduces the mechanical stress acting on the vessel walls. • Fluid-structure interaction analysis for different configurations of the arteriovenous fistula. • Mismatch of the arterial and venous Young's moduli and different vessel thicknesses. • Real reconstruction of the shape of the anastomosis region. • The diameter of the cephalic vein drastically influences the hemodynamics. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a systemic disease that leads to accumulation of deposits, known as atherosclerotic plaques, within the walls of the carotids. In particular, three types of plaque can be distinguished: soft, fibrous, and calcific. Most of the computational studies who investigated the interplay between the plaque and the blood flow on patient-specific geometries used nonstandard medical images to directly delineate and segment the plaque and its components. However, these techniques are not so widely available in the clinical practice. In this context, the aim of our work was twofold: (i) to propose a new geometric tool that allowed to reconstruct a plausible plaque in the carotids from standard images and (ii) to perform three-dimensional (3D) fluid-structure interaction (FSI) simulations where we compared some fluid-dynamic and structural quantities among 15 patients characterized by different typologies of plaque. Our results highlighted that both the morphology and the mechanical properties of different plaque components play a crucial role in determining the vulnerability of the plaque. [ABSTRACT FROM AUTHOR]

We consider a loosely-coupled algorithm for fluid-structure interaction based on a Robin interface condition for the fluid problem (explicit Robin-Neumann scheme). We study the dependence of the stability of this method on the interface parameter in the Robin condition. In particular, for a model problem we find sufficient conditions for instability and stability of the method. In the latter case, we find a stability condition relating the time discretization parameter, the interface parameter, and the fluid and structure densities. Numerical experiments confirm the theoretical findings and highlight optimal choices of the interface parameter that guarantee accurate solutions. [ABSTRACT FROM AUTHOR]

Transcatheter aortic valve implantation (TAVI) is a minimally invasive intervention for the treatment of severe aortic valve stenosis. The main cause of failure is the structural deterioration of the implanted prosthetic leaflets, possibly inducing a valvular re‐stenosis 5–10 years after the implantation. Based solely on pre‐implantation data, the aim of this work is to identify fluid‐dynamics and structural indices that may predict the possible valvular deterioration, in order to assist the clinicians in the decision‐making phase and in the intervention design. Patient‐specific, pre‐implantation geometries of the aortic root, the ascending aorta, and the native valvular calcifications were reconstructed from computed tomography images. The stent of the prosthesis was modeled as a hollow cylinder and virtually implanted in the reconstructed domain. The fluid‐structure interaction between the blood flow, the stent, and the residual native tissue surrounding the prosthesis was simulated by a computational solver with suitable boundary conditions. Hemodynamical and structural indicators were analyzed for five different patients that underwent TAVI – three with prosthetic valve degeneration and two without degeneration – and the comparison of the results showed a correlation between the leaflets' structural degeneration and the wall shear stress distribution on the proximal aortic wall. This investigation represents a first step towards computational predictive analysis of TAVI degeneration, based on pre‐implantation data and without requiring additional peri‐operative or follow‐up information. Indeed, being able to identify patients more likely to experience degeneration after TAVI may help to schedule a patient‐specific timing of follow‐up. [ABSTRACT FROM AUTHOR]

Numerical simulations of cardiac blood pump systems are integral to the optimization of device design, hydraulic performance and hemocompatibility. In wave membrane blood pumps, blood propulsion arises from the wave propagation along an oscillating immersed membrane, which generates small pockets of fluid that are pushed towards the outlet against an adverse pressure gradient. We studied the Fluid–Structure Interaction between the oscillating membrane and the blood flow via three‐dimensional simulations using the Extended Finite Element Method (XFEM), an unfitted numerical technique that avoids remeshing by using a fluid fixed mesh. Our three‐dimensional numerical simulations in a realistic pump geometry highlighted, for the first time in this field of application, that XFEM is a reliable strategy to handle complex industrial problems. Moreover, they showed the role of the membrane deformation in promoting a blood flow towards the outlet despite an adverse pressure gradient. We also simulated the pump system at different pressure conditions and we validated the numerical results against in‐vitro experimental data. [ABSTRACT FROM AUTHOR]

We present a loosely coupled scheme for the numerical simulation of the cardiac electro-fluid-structure interaction problem, whose solution is typically computationally intensive due to the need to suitably treat the coupling of the different submodels. Our scheme relies on a segregated treatment of the subproblems, in particular on an explicit Robin-Neumann algorithm for the fluid-structure interaction, aiming at reducing the computational burden of numerical simulations. The results, both in an ideal and a realistic cardiac setting, show that the proposed scheme is stable at the regimes typical of cardiac simulations. From a comparison with a scheme with implicit fluid-structure interaction, it emerges that, while conservation properties are not fully preserved, computational times significantly benefit from the explicit scheme. Overall, the explicit discretization represents a good trade-off between accuracy and cost, and is a valuable alternative to implicit schemes for fast large-scale simulations. • We present an explicit scheme for the simulation of cardiac electro-fluid-structure interaction. • The scheme uses Robin-Neumann fluid-structure interface conditions. • We analyze the stability, accuracy and efficiency of the explicit scheme. • The explicit scheme provides a compromise between accuracy and computational cost. [ABSTRACT FROM AUTHOR]