{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T04:01:36Z","timestamp":1793764896549,"version":"4.6.1"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Progressive aortic valve disease has remained a persistent cause of concern in patients with left ventricular assist devices. Aortic incompetence (AI) is a known predictor of both mortality and readmissions in this patient population and remains a challenging clinical problem.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Ten left ventricular assist device patients with de novo aortic regurgitation and 19 control left ventricular assist device patients were identified. Three-dimensional models of patients\u2019 aortas were created from their computed tomography scans, following which large-scale patient-specific computational fluid dynamics simulations were performed with physiologically accurate boundary conditions using the SimVascular flow solver.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              The spatial distributions of time-averaged wall shear stress and oscillatory shear index show no significant differences in the aortic root in patients with and without AI (mean difference, 0.67 dyne\/cm\n              <jats:sup>2<\/jats:sup>\n              [95% CI, \u22120.51 to 1.85];\n              <jats:italic>P<\/jats:italic>\n              =0.23). Oscillatory shear index was also not significantly different between both groups of patients (mean difference, 0.03 [95% CI, \u22120.07 to 0.019];\n              <jats:italic>P<\/jats:italic>\n              =0.22). The localized wall shear stress on the leaflet tips was significantly higher in the AI group than the non-AI group (1.62 versus 1.35 dyne\/cm\n              <jats:sup>2<\/jats:sup>\n              ; mean difference [95% CI, 0.15\u20130.39];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), whereas oscillatory shear index was not significantly different between both groups (95% CI, \u22120.009 to 0.001;\n              <jats:italic>P<\/jats:italic>\n              =0.17).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Computational fluid dynamics serves a unique role in studying the hemodynamic features in left ventricular assist device patients where 4-dimensional magnetic resonance imaging remains unfeasible. Contrary to the widely accepted notions of highly disturbed flow, in this study, we demonstrate that the aortic root is a region of relatively stagnant flow. We further identified localized hemodynamic features in the aortic root that challenge our understanding of how AI develops in this patient population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.120.008034","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T09:00:19Z","timestamp":1624006819000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Patient-Specific Computational Fluid Dynamics Reveal Localized Flow Patterns Predictive of Post\u2013Left Ventricular Assist Device Aortic Incompetence"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0453-9041","authenticated-orcid":true,"given":"Rohan","family":"Shad","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7241-9773","authenticated-orcid":true,"given":"Alexander D.","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Institute for Computational and Mathematical Engineering (A.D.K., A.L.M.), Stanford University School of Medicine."},{"name":"Department of Pediatrics\u2014Cardiology (A.D.K., A.L.M.), Stanford University School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6792-5185","authenticated-orcid":true,"given":"Nicolas","family":"Quach","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cayley","family":"Bowles","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patpilai","family":"Kasinpila","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Shudo","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Teuteberg","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University School of Medicine (R.S., S.K., R.F., N.Q., C.B., P.K., Y.S., J.T., Y.J.W., W.H.)."},{"name":"Stanford University, Department of Medicine\u2014Cardiovascular Medicine (J.T.), Stanford University School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2506-492X","authenticated-orcid":true,"given":"Y. 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