{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:55:11Z","timestamp":1785750911684,"version":"3.56.0"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006919","name":"Massachusetts Institute of Technology","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006919","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Eng Tech"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia that increases the risk of stroke, primarily due to thrombus formation in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) devices offer an alternative to oral anticoagulation for stroke prevention. However, the complex and variable anatomy of the LAA presents significant challenges to device design and deployment. Current benchtop models fail to replicate both anatomical variability and physiological hemodynamics, limiting their utility. This study introduces a novel left atrial cardiac simulator that incorporates patient-derived LAA models within a benchtop circulatory flow loop, enabling high-fidelity LAAO device testing and development.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A rigid, patient-derived left atrium (LA) model was 3D printed from segmented MRI data and modified to accommodate attachment of patient-specific LAA models. A library of LAA geometries was fabricated using silicone casting techniques to replicate the mechanical properties of native tissue. The LA-LAA model was integrated into a circulatory flow loop equipped with a pulsatile pump, pressure sensors, and flow probes, allowing real-time hemodynamic analysis. System tunability was demonstrated by varying heart rate, stroke volume, resistance, and compliance to simulate physiological and pathological conditions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The simulator accurately replicated LA pressure and flow waveforms, closely approximating physiological conditions. Changes in heart rate, stroke volume, and compliance effectively modulated LAP and LA inflow before and after LAAO. Distinct pressure and flow waveforms were observed with different LAA geometries. Hemodynamic analysis revealed increased left atrial pulse pressure after occlusion, with the greatest increase occurring after complete exclusion of the LAA. The simulator facilitated the evaluation of LAAO device performance, including metrics such as seal and PDL, and served as an effective training tool for iterative device deployment and recapture with visual and imaging-guided feedback.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The left atrial cardiac simulator offers a highly tunable and realistic platform for testing and developing LAAO devices. It also serves as an effective procedural training tool, allowing for the simulation of patient-specific anatomical and hemodynamic conditions. By enabling these advanced simulations, the simulator enhances pre-procedural planning, device sizing, and placement. This innovation represents a significant step toward advancing personalized medicine in atrial fibrillation management and improving LAAO outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s13239-025-00773-2","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T19:33:17Z","timestamp":1738006397000},"page":"279-295","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Design and Validation of a High-Fidelity Left Atrial Cardiac Simulator for the Study and Advancement of Left Atrial Appendage Occlusion"],"prefix":"10.1007","volume":"16","author":[{"given":"Keegan","family":"Mendez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Willoughby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Ncho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elijah","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Alkhouli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Alarouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8952-2993","authenticated-orcid":false,"given":"Ellen T.","family":"Roche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"773_CR1","doi-asserted-by":"publisher","unstructured":"Al-Saady, N.M., Obel, O.A., and Camm, A.J. (1999). Left atrial appendage: Structure, function, and role in thromboembolism. Preprint, https:\/\/doi.org\/10.1136\/hrt.82.5.547.","DOI":"10.1136\/hrt.82.5.547"},{"key":"773_CR2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1949.02900440011003","author":"JL MADDEN","year":"1949","unstructured":"MADDEN, J.L. (1949). Resection of the left auricular appendix; a prophylaxis for recurrent. J Am Med Assoc. https:\/\/doi.org\/10.1001\/jama.1949.02900440011003.","journal-title":"J Am Med Assoc"},{"key":"773_CR3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000140263.20897.42","author":"DM Lloyd-Jones","year":"2004","unstructured":"Lloyd-Jones, D.M., Wang, T.J., Leip, E.P., Larson, M.G., Levy, D., Vasan, R.S., D\u2019Agostino, R.B., Massaro, J.M., Beiser, A., Wolf, P.A., et al. (2004). Lifetime risk for development of atrial fibrillation: The framingham heart study. Circulation. https:\/\/doi.org\/10.1161\/01.CIR.0000140263.20897.42.","journal-title":"Circulation"},{"key":"773_CR4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi825","author":"J Heeringa","year":"2006","unstructured":"Heeringa, J., Van Der Kuip, D.A.M., Hofman, A., Kors, J.A., Van Herpen, G., Stricker, B.H.C., Stijnen, T., Lip, G.Y.H., and Witteman, J.C.M. (2006). Prevalence, incidence and lifetime risk of atrial fibrillation: The Rotterdam study. Eur Heart J. https:\/\/doi.org\/10.1093\/eurheartj\/ehi825.","journal-title":"Eur Heart J"},{"key":"773_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.04.032","author":"L Di Biase","year":"2012","unstructured":"Di Biase, L., Santangeli, P., Anselmino, M., Mohanty, P., Salvetti, I., Gili, S., Horton, R., Sanchez, J.E., Bai, R., Mohanty, S., et al. (2012). Does the left atrial appendage morphology correlate with the risk of stroke in patients with atrial fibrillation? Results from a multicenter study. J Am Coll Cardiol. https:\/\/doi.org\/10.1016\/j.jacc.2012.04.032.","journal-title":"J Am Coll Cardiol"},{"key":"773_CR6","doi-asserted-by":"publisher","unstructured":"Lee, J.M., Shim, J., Uhm, J.-S.S., Kim, Y.J., Lee, H.-J.J., Pak, H.-N.N., Lee, M.-H.H., and Joung, B. (2014). Impact of increased orifice size and decreased flow velocity of left atrial appendage on stroke in nonvalvular atrial fibrillation. American Journal of Cardiology 113. https:\/\/doi.org\/10.1016\/j.amjcard.2013.11.058.","DOI":"10.1016\/j.amjcard.2013.11.058"},{"key":"773_CR7","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1016\/j.jacc.2011.11.028","volume":"59","author":"JF Viles-Gonzalez","year":"2012","unstructured":"Viles-Gonzalez, J.F., Kar, S., Douglas, P., Dukkipati, S., Feldman, T., Horton, R., Holmes, D., and Reddy, V.Y. (2012). The clinical impact of incomplete left atrial appendage closure with the watchman device in patients with atrial fibrillation. J Am Coll Cardiol 59, 923\u2013929.","journal-title":"J Am Coll Cardiol"},{"key":"773_CR8","doi-asserted-by":"publisher","unstructured":"Blackshear, J.L., and Odell, J.A. (1996). Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Preprint, https:\/\/doi.org\/10.1016\/0003-4975(95)00887-X.","DOI":"10.1016\/0003-4975(95)00887-X"},{"key":"773_CR9","doi-asserted-by":"publisher","unstructured":"Fender, E.A., Kiani, J.G., and Holmes, D.R. (2016). Left Atrial Appendage Closure for Stroke Prevention in Atrial Fibrillation. Preprint, https:\/\/doi.org\/10.1007\/s11883-016-0616-z.","DOI":"10.1007\/s11883-016-0616-z"},{"key":"773_CR10","doi-asserted-by":"publisher","unstructured":"Alli, O.O., and Holmes, D.R. (2015). Left Atrial Appendage Occlusion for Stroke Prevention. Curr Probl Cardiol. https:\/\/doi.org\/10.1016\/j.cpcardiol.2015.06.005.","DOI":"10.1016\/j.cpcardiol.2015.06.005"},{"key":"773_CR11","doi-asserted-by":"publisher","unstructured":"Hart, R.G., Diener, H.C., Yang, S., Connolly, S.J., Wallentin, L., Reilly, P.A., Ezekowitz, M.D., and Yusuf, S. (2012). Intracranial hemorrhage in atrial fibrillation patients during anticoagulation with warfarin or dabigatran: The RE-LY trial. Stroke. https:\/\/doi.org\/10.1161\/STROKEAHA.112.650614.","DOI":"10.1161\/STROKEAHA.112.650614"},{"key":"773_CR12","doi-asserted-by":"publisher","unstructured":"De Backer, O., Arnous, S., Ihlemann, N., Vejlstrup, N., J\u00f8rgensen, E., Pehrson, S., Krieger, T.D.W., Meier, P., S\u00f8ndergaard, L., and Franzen, O.W. (2014). Percutaneous left atrial appendage occlusion for stroke prevention in atrial fibrillation: An update. Preprint at BMJ Publishing Group, https:\/\/doi.org\/10.1136\/openhrt-2013-000020.","DOI":"10.1136\/openhrt-2013-000020"},{"key":"773_CR13","doi-asserted-by":"publisher","unstructured":"Singh, I.M., and Holmes, D.R. (2010). Left atrial appendage closure. Preprint, https:\/\/doi.org\/10.1007\/s11886-010-0122-9.","DOI":"10.1007\/s11886-010-0122-9"},{"key":"773_CR14","doi-asserted-by":"publisher","unstructured":"Wunderlich, N.C., Beigel, R., Swaans, M.J., Ho, S.Y., and Siegel, R.J. (2015). Percutaneous Interventions for Left Atrial Appendage Exclusion. JACC Cardiovasc Imaging. https:\/\/doi.org\/10.1016\/j.jcmg.2015.02.002.","DOI":"10.1016\/j.jcmg.2015.02.002"},{"key":"773_CR15","doi-asserted-by":"publisher","unstructured":"Glikson, M., Wolff, R., Hindricks, G., Mandrola, J., Camm, A.J., Lip, G.Y.H.H., Fauchier, L., Betts, T.R., Lewalter, T., Saw, J., et al. (2020). EHRA\/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion \u2013 an update. EuroIntervention 15. https:\/\/doi.org\/10.1093\/europace\/euz258.","DOI":"10.1093\/europace\/euz258"},{"key":"773_CR16","doi-asserted-by":"publisher","unstructured":"Collado, F.M.S., Lama von Buchwald, C.M., Anderson, C.K., Madan, N., Suradi, H.S., Huang, H.D., Jneid, H., and Kavinsky, C.J. (2021). Left Atrial Appendage Occlusion for Stroke Prevention in Nonvalvular Atrial Fibrillation. J Am Heart Assoc 10. https:\/\/doi.org\/10.1161\/JAHA.121.022274.","DOI":"10.1161\/JAHA.121.022274"},{"key":"773_CR17","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1093\/eurheartj\/ehad828","volume":"45","author":"A Samaras","year":"2024","unstructured":"Samaras, A., Papazoglou, A.S., Balomenakis, C., Bekiaridou, A., Moysidis, D. V, Patsiou, V., Orfanidis, A., Giannakoulas, G., Kassimis, G., Fragakis, N., et al. (2024). Residual leaks following percutaneous left atrial appendage occlusion and outcomes: a meta-analysis. Eur Heart J 45, 214\u2013229. https:\/\/doi.org\/10.1093\/eurheartj\/ehad828.","journal-title":"Eur Heart J"},{"key":"773_CR52","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/j.jcin.2022.12.006","volume":"16","author":"M Alkhouli","year":"2023","unstructured":"Alkhouli, M., De Backer, O., Ellis, C.R., Nielsen-Kudsk, J.E., Sievert, H., Natale, A., Lakkireddy, D., and Holmes, D.R. (2023). Peridevice Leak After Left Atrial Appendage Occlusion. JACC Cardiovasc Interv 16, 627\u2013642. https:\/\/doi.org\/10.1016\/j.jcin.2022.12.006.","journal-title":"JACC Cardiovasc Interv"},{"key":"773_CR18","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.1016\/j.jacc.2018.01.076","volume":"71","author":"L Fauchier","year":"2018","unstructured":"Fauchier, L., Cinaud, A., Brigadeau, F., Lepillier, A., Pierre, B., Abbey, S., Fatemi, M., Franceschi, F., Guedeney, P., Jacon, P., et al. (2018). Device-Related Thrombosis After Percutaneous Left Atrial Appendage Occlusion for Atrial Fibrillation. J Am Coll Cardiol 71, 1528\u20131536. https:\/\/doi.org\/10.1016\/j.jacc.2018.01.076.","journal-title":"J Am Coll Cardiol"},{"key":"773_CR19","doi-asserted-by":"crossref","unstructured":"Sedaghat, A., Vij, V., Al-Kassou, B., Gloekler, S., Galea, R., F\u00fcrholz, M., Meier, B., Valgimigli, M., O\u2019Hara, G., Arzamendi, D., et al. (2021). Device-Related Thrombus After Left Atrial Appendage Closure: Data on Thrombus Characteristics, Treatment Strategies, and Clinical Outcomes From the EUROC-DRT-Registry. Circ Cardiovasc Interv 14.","DOI":"10.1161\/CIRCINTERVENTIONS.120.010195"},{"key":"773_CR20","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.jacc.2021.04.098","volume":"78","author":"T Simard","year":"2021","unstructured":"Simard, T., Jung, R.G., Lehenbauer, K., Piayda, K., Praco\u0144, R., Jackson, G.G., Flores-Umanzor, E., Faroux, L., Korsholm, K., Chun, J.K.R., et al. (2021). Predictors of Device-Related Thrombus Following Percutaneous Left Atrial Appendage Occlusion. J Am Coll Cardiol 78, 297\u2013313. https:\/\/doi.org\/10.1016\/j.jacc.2021.04.098.","journal-title":"J Am Coll Cardiol"},{"key":"773_CR21","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1161\/CIRCULATIONAHA.118.035090","volume":"138","author":"SR Dukkipati","year":"2018","unstructured":"Dukkipati, S.R., Kar, S., Holmes, D.R., Doshi, S.K., Swarup, V., Gibson, D.N., Maini, B., Gordon, N.T., Main, M.L., and Reddy, V.Y. (2018). Device-Related Thrombus After Left Atrial Appendage Closure. Circulation 138, 874\u2013885. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.118.035090.","journal-title":"Circulation"},{"key":"773_CR22","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1016\/j.jacep.2018.09.007","volume":"4","author":"M Alkhouli","year":"2018","unstructured":"Alkhouli, M., Busu, T., Shah, K., Osman, M., Alqahtani, F., and Raybuck, B. (2018). Incidence and Clinical Impact of Device-Related Thrombus Following Percutaneous Left Atrial Appendage Occlusion. JACC Clin Electrophysiol 4, 1629\u20131637. https:\/\/doi.org\/10.1016\/j.jacep.2018.09.007.","journal-title":"JACC Clin Electrophysiol"},{"key":"773_CR23","doi-asserted-by":"publisher","unstructured":"Bosi, G.M., Cook, A., Rai, R., Menezes, L.J., Schievano, S., Torii, R., and Burriesci, G. (2018). Computational Fluid Dynamic Analysis of the Left Atrial Appendage to Predict Thrombosis Risk. Front Cardiovasc Med 5. https:\/\/doi.org\/10.3389\/fcvm.2018.00034.","DOI":"10.3389\/fcvm.2018.00034"},{"key":"773_CR24","doi-asserted-by":"publisher","unstructured":"Mill, J., Agudelo, V., Hion Li, C., Noailly, J., Freixa, X., Camara, O., and Dabit Arzamendi, and (2022). Patient-specific flow simulation analysis to predict device-related thrombosis in left atrial appendage occluders. REC: interventional cardiology (English Edition). https:\/\/doi.org\/10.24875\/RECICE.M21000224.","DOI":"10.24875\/RECICE.M21000224"},{"key":"773_CR25","doi-asserted-by":"publisher","unstructured":"Danielli, F., Berti, F., Fanni, B.M., Gasparotti, E., Celi, S., Pennati, G., and Petrini, L. (2024). Left atrial appendage occlusion: On the need of a numerical model to simulate the implant procedure. Int J Numer Method Biomed Eng 40. https:\/\/doi.org\/10.1002\/cnm.3814.","DOI":"10.1002\/cnm.3814"},{"key":"773_CR26","unstructured":"mentice (2023). Left Atrial Appendage Occlusion. mentice. https:\/\/www.mentice.com\/software\/left-atrial-appendage-occlusion."},{"key":"773_CR27","doi-asserted-by":"publisher","DOI":"10.1108\/RPJ-03-2024-0126","author":"BM Fanni","year":"2024","unstructured":"Fanni, B.M., Gasparotti, E., Esposito, A., Danielli, F., Berti, F., Berti, S., Pennati, G., Petrini, L., and Celi, S. (2024). A high-fidelity personalised 3d printed simulator for the left atrial appendage occlusion procedure. Rapid Prototyp J. https:\/\/doi.org\/10.1108\/RPJ-03-2024-0126.","journal-title":"Rapid Prototyp J"},{"key":"773_CR28","doi-asserted-by":"publisher","first-page":"101339","DOI":"10.1016\/j.jacadv.2024.101339","volume":"3","author":"BJ Vogl","year":"2024","unstructured":"Vogl, B.J., Vitale, E., Ahn, S., Sularz, A., Chavez Ponce, A., Lo Russo, G. V., Collins, J., Bavo, A.M., El Shaer, A., Kramer, A., et al. (2024). Flow Dynamic Factors Correlated With Device-Related Thrombosis After Left Atrial Appendage Occlusion. JACC: Advances 3, 101339. https:\/\/doi.org\/10.1016\/j.jacadv.2024.101339.","journal-title":"JACC: Advances"},{"key":"773_CR29","doi-asserted-by":"publisher","unstructured":"Roney, C.H., Sim, I., Yu, J., Beach, M., Mehta, A., Alonso Solis-Lemus, J., Kotadia, I., Whitaker, J., Corrado, C., Razeghi, O., et al. (2022). Predicting Atrial Fibrillation Recurrence by Combining Population Data and Virtual Cohorts of Patient-Specific Left Atrial Models. Circ Arrhythm Electrophysiol 15. https:\/\/doi.org\/10.1161\/CIRCEP.121.010253.","DOI":"10.1161\/CIRCEP.121.010253"},{"key":"773_CR30","doi-asserted-by":"publisher","first-page":"8431","DOI":"10.1038\/s41598-021-87859-8","volume":"11","author":"YJ van de Vegte","year":"2021","unstructured":"van de Vegte, Y.J., Siland, J.E., Rienstra, M., and van der Harst, P. (2021). Atrial fibrillation and left atrial size and function: a Mendelian randomization study. Sci Rep 11, 8431. https:\/\/doi.org\/10.1038\/s41598-021-87859-8.","journal-title":"Sci Rep"},{"key":"773_CR31","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/j.hrthm.2015.12.026","volume":"13","author":"WK Jeong","year":"2016","unstructured":"Jeong, W.K., Choi, J.-H., Son, J.P., Lee, S., Lee, M.J., Choe, Y.H., and Bang, O.Y. (2016). Volume and morphology of left atrial appendage as determinants of stroke subtype in patients with atrial fibrillation. Heart Rhythm 13, 820\u2013827. https:\/\/doi.org\/10.1016\/j.hrthm.2015.12.026.","journal-title":"Heart Rhythm"},{"key":"773_CR32","doi-asserted-by":"publisher","first-page":"3112","DOI":"10.1161\/01.CIR.96.9.3112","volume":"96","author":"JP Veinot","year":"1997","unstructured":"Veinot, J.P., Harrity, P.J., Gentile, F., Khandheria, B.K., Bailey, K.R., Eickholt, J.T., Seward, J.B., Tajik, A.J., and Edwards, W.D. (1997). Anatomy of the Normal Left Atrial Appendage. Circulation 96, 3112\u20133115. https:\/\/doi.org\/10.1161\/01.CIR.96.9.3112.","journal-title":"Circulation"},{"key":"773_CR33","doi-asserted-by":"publisher","first-page":"e0143853","DOI":"10.1371\/journal.pone.0143853","volume":"10","author":"J Park","year":"2015","unstructured":"Park, J., Yang, P., Kim, T.-H., Uhm, J.-S., Kim, J.-Y., Joung, B., Lee, M.-H., Hwang, C., and Pak, H.-N. (2015). Low Left Atrial Compliance Contributes to the Clinical Recurrence of Atrial Fibrillation after Catheter Ablation in Patients with Structurally and Functionally Normal Heart. PLoS One 10, e0143853. https:\/\/doi.org\/10.1371\/journal.pone.0143853.","journal-title":"PLoS One"},{"key":"773_CR34","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1038\/s41598-024-52327-6","volume":"14","author":"M Meskin","year":"2024","unstructured":"Meskin, M., Starkey, P.A., Kaspersen, A.E., Ringgaard, S., Sand, S.G., Nygaard, J.V., Jensen, J.A., Traberg, M.S., and Johansen, P. (2024). Investigating the importance of left atrial compliance on fluid dynamics in a novel mock circulatory loop. Sci Rep 14, 1864. https:\/\/doi.org\/10.1038\/s41598-024-52327-6.","journal-title":"Sci Rep"},{"key":"773_CR35","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.media.2019.04.004","volume":"55","author":"CH Roney","year":"2019","unstructured":"Roney, C.H., Pashaei, A., Meo, M., Dubois, R., Boyle, P.M., Trayanova, N.A., Cochet, H., Niederer, S.A., and Vigmond, E.J. (2019). Universal atrial coordinates applied to visualisation, registration and construction of patient specific meshes. Med Image Anal 55, 65\u201375. https:\/\/doi.org\/10.1016\/j.media.2019.04.004.","journal-title":"Med Image Anal"},{"key":"773_CR36","unstructured":"Fleitman, J. (2024). Pulmonary artery catheterization: Interpretation of hemodynamic values and waveforms in adults. UpToDate."},{"key":"773_CR37","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1111\/j.1540-8175.2000.tb01153.x","volume":"17","author":"IW BLACK","year":"2000","unstructured":"BLACK, I.W. (2000). Spontaneous Echo Contrast: Where There\u2019s Smoke There\u2019s Fire. Echocardiography 17, 373\u2013382. https:\/\/doi.org\/10.1111\/j.1540-8175.2000.tb01153.x.","journal-title":"Echocardiography"},{"key":"773_CR38","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/S0894-7317(14)80213-7","volume":"4","author":"MA Basnight","year":"1991","unstructured":"Basnight, M.A., Gonzalez, M.S., Kershenovich, S.C., and Appleton, C.P. (1991). Pulmonary Venous Flow Velocity: Relation to Hemodynamics, Mitral Flow Velocity and Left Atrial Volume, and Ejection Fraction. Journal of the American Society of Echocardiography 4, 547\u2013558. https:\/\/doi.org\/10.1016\/S0894-7317(14)80213-7.","journal-title":"Journal of the American Society of Echocardiography"},{"key":"773_CR39","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1093\/oxfordjournals.eurheartj.a015097","volume":"18","author":"F Gentile","year":"1997","unstructured":"Gentile, F., Mantero, A., Lippolis, A., Ornaghi, M., Azzollini, M., Barbier, P., Beretta, L., Casazza, F., Corno, R., Faletra, F., et al. (1997). Pulmonary venous flow velocity patterns in 143 normal subjects aged 20 to 80 years old: An echo 2D colour Doppler cooperative study. Eur Heart J 18, 148\u2013164. https:\/\/doi.org\/10.1093\/oxfordjournals.eurheartj.a015097.","journal-title":"Eur Heart J"},{"key":"773_CR40","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/0002-9149(94)90015-9","volume":"73","author":"IA Paraskevaidis","year":"1994","unstructured":"Paraskevaidis, I.A., Kremastinos, D.T., Matsakas, E.P., Tsetsos, G.A., Theodorakis, G.N., and Toutouzas, P.K. (1994). Transesophageal detection of early systolic reverse pulmonary venous flow in atrial fibrillation. Am J Cardiol 73, 392\u2013396. https:\/\/doi.org\/10.1016\/0002-9149(94)90015-9.","journal-title":"Am J Cardiol"},{"key":"773_CR41","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1093\/eurheartj\/14.10.1320","volume":"14","author":"WD REN","year":"1993","unstructured":"REN, W.D., VISENTIN, P., NICOLOSI, G.L., CANTERIN, F.A., DALL\u2019AGLIO, V., LESTUZZI, C., MIMO, R., PAVAN, D., SPARACINO, L., CERVESATO, E., et al. (1993). Effect of atrial fibrillation on pulmonary venous flow patterns: transoesophageal pulsed Doppler echocardiographic study. Eur Heart J 14, 1320\u20131327. https:\/\/doi.org\/10.1093\/eurheartj\/14.10.1320.","journal-title":"Eur Heart J"},{"key":"773_CR42","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1378\/chest.117.6.1546","volume":"117","author":"T-H Chao","year":"2000","unstructured":"Chao, T.-H., Tsai, L.-M., Tsai, W.-C., Li, Y.-H., Lin, L.-J., and Chen, J.-H. (2000). Effect of Atrial Fibrillation on Pulmonary Venous Flow Patterns Assessed by Doppler Transesophageal Echocardiography. Chest 117, 1546\u20131550. https:\/\/doi.org\/10.1378\/chest.117.6.1546.","journal-title":"Chest"},{"key":"773_CR43","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-017-1289-6","author":"E Obasare","year":"2017","unstructured":"Obasare, E., Mainigi, S.K., Morris, D.L., Slipczuk, L., Goykhman, I., Friend, E., Ziccardi, M.R., and Pressman, G.S. (2017). CT based 3D printing is superior to transesophageal echocardiography for pre-procedure planning in left atrial appendage device closure. Int J Cardiovasc Imaging. https:\/\/doi.org\/10.1007\/s10554-017-1289-6.","journal-title":"Int J Cardiovasc Imaging"},{"key":"773_CR44","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/j.jcin.2015.03.015","volume":"8","author":"JM Otton","year":"2015","unstructured":"Otton, J.M., Spina, R., Sulas, R., Subbiah, R.N., Jacobs, N., Muller, D.W.M., and Gunalingam, B. (2015). Left Atrial Appendage Closure Guided by Personalized 3D-Printed Cardiac Reconstruction. JACC Cardiovasc Interv 8, 1004\u20131006. https:\/\/doi.org\/10.1016\/j.jcin.2015.03.015.","journal-title":"JACC Cardiovasc Interv"},{"key":"773_CR45","doi-asserted-by":"publisher","unstructured":"Liu, P., Liu, R., Zhang, Y., Liu, Y., Tang, X., and Cheng, Y. (2016). The Value of 3D Printing Models of Left Atrial Appendage Using Real-Time 3D Transesophageal Echocardiographic Data in Left Atrial Appendage Occlusion: Applications toward an Era of Truly Personalized Medicine. Cardiology 135. https:\/\/doi.org\/10.1159\/000447444.","DOI":"10.1159\/000447444"},{"key":"773_CR46","doi-asserted-by":"publisher","first-page":"2329","DOI":"10.1016\/j.jcin.2016.07.038","volume":"9","author":"DD Wang","year":"2016","unstructured":"Wang, D.D., Eng, M., Kupsky, D., Myers, E., Forbes, M., Rahman, M., Zaidan, M., Parikh, S., Wyman, J., Pantelic, M., et al. (2016). Application of 3-Dimensional Computed Tomographic Image Guidance to WATCHMAN Implantation and Impact on Early Operator Learning Curve. JACC Cardiovasc Interv 9, 2329\u20132340. https:\/\/doi.org\/10.1016\/j.jcin.2016.07.038.","journal-title":"JACC Cardiovasc Interv"},{"key":"773_CR47","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1016\/j.hrthm.2024.02.022","volume":"21","author":"HS Alarouri","year":"2024","unstructured":"Alarouri, H.S., Lo Russo, G. V., Chavez Ponce, A., Akkawi, A.-R., Mahayni, A., Sularz, A., Killu, A.M., Simard, T., Singh, G., Miranda, W.R., et al. (2024). Association of transcatheter left atrial appendage occlusion with acute changes in left atrial pressure: An invasive hemodynamic study. Heart Rhythm 21, 1024\u20131031. https:\/\/doi.org\/10.1016\/j.hrthm.2024.02.022.","journal-title":"Heart Rhythm"},{"key":"773_CR54","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1038\/s41598-024-52327-6","volume":"14","author":"M Meskin","year":"2024","unstructured":"Meskin, M., Starkey, P.A., Kaspersen, A.E., Ringgaard, S., Sand, S.G., Nygaard, J.V., Jensen, J.A., Traberg, M.S., and Johansen, P. (2024). Investigating the importance of left atrial compliance on fluid dynamics in a novel mock circulatory loop. Sci Rep 14, 1864. https:\/\/doi.org\/10.1038\/s41598-024-52327-6.","journal-title":"Sci Rep"},{"key":"773_CR48","doi-asserted-by":"publisher","unstructured":"Park, C., Singh, M., Saeed, M.Y., Nguyen, C.T., and Roche, E.T. (2024). Biorobotic hybrid heart as a benchtop cardiac mitral valve simulator. Device 2, 100217. https:\/\/doi.org\/10.1016\/j.device.2023.100217.","DOI":"10.1016\/j.device.2023.100217"},{"key":"773_CR49","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1038\/s44161-023-00387-8","volume":"2","author":"M Singh","year":"2023","unstructured":"Singh, M., Bonnemain, J., Ozturk, C., Ayers, B., Saeed, M.Y., Quevedo-Moreno, D., Rowlett, M., Park, C., Fan, Y., Nguyen, C.T., et al. (2023). Robotic right ventricle is a biohybrid platform that simulates right ventricular function in (patho)physiological conditions and intervention. Nature Cardiovascular Research 2, 1310\u20131326. https:\/\/doi.org\/10.1038\/s44161-023-00387-8.","journal-title":"Nature Cardiovascular Research"},{"key":"773_CR50","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1016\/j.jacc.2023.01.017","volume":"81","author":"M Alkhouli","year":"2023","unstructured":"Alkhouli, M., Di Biase, L., Natale, A., Rihal, C.S., Holmes, D.R., Asirvatham, S., Bartus, K., Lakkireddy, D., and Friedman, P.A. (2023). Nonthrombogenic Roles of the Left Atrial Appendage. J Am Coll Cardiol 81, 1063\u20131075. https:\/\/doi.org\/10.1016\/j.jacc.2023.01.017.","journal-title":"J Am Coll Cardiol"},{"key":"773_CR51","doi-asserted-by":"publisher","unstructured":"Raphael, C., Friedman, P., Saw, J., Pislaru, S., Munger, T., and Holmes, D. (2017). Residual leaks following percutaneous left atrial appendage occlusion: assessment and management implications. EuroIntervention 13, 1218\u20131225. https:\/\/doi.org\/10.4244\/EIJ-D-17-00469.","DOI":"10.4244\/EIJ-D-17-00469"},{"key":"773_CR53","doi-asserted-by":"publisher","first-page":"e1033","DOI":"10.4244\/EIJ-D-21-00286","volume":"17","author":"K Piayda","year":"2021","unstructured":"Piayda, K., Sievert, K., Della Rocca, D.G., Adeola, O.G., Alkhouli, M., Yoo, D., Benito-Gonz\u00e1lez, T., Cruz-Gonz\u00e1lez, I., Galea, R., Skurk, C., et al. (2021). Safety and feasibility of peri-device leakage closure after LAAO: an international, multicentre collaborative study. EuroIntervention 17, e1033\u2013e1040. https:\/\/doi.org\/10.4244\/EIJ-D-21-00286.","journal-title":"EuroIntervention"}],"container-title":["Cardiovascular Engineering and Technology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13239-025-00773-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13239-025-00773-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13239-025-00773-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T17:11:23Z","timestamp":1748884283000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13239-025-00773-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["773"],"URL":"https:\/\/doi.org\/10.1007\/s13239-025-00773-2","relation":{},"ISSN":["1869-408X","1869-4098"],"issn-type":[{"value":"1869-408X","type":"print"},{"value":"1869-4098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]},"assertion":[{"value":"23 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Patrick Willoughby and Beatrice Ncho are employees of Boston Scientific. Mohamad Alkhouli is on the advisory board for Boston Scientific, Abbott, and Philips. Ellen T. Roche is on the Board of Directors for Affluent Medical and on the advisory board for Fada Medical and Helios Cardio. All other authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}