Hypertrophic Cardiomyopathy Treatment – A Numerical Study

Considered the leading cause of sudden cardiac death (SCD) in athletes, Hypertrophic Cardiomyopathy (HCM) is diagnosed in up to one of 200 people of the general population, regardless of prior medical condition. A common complication of HCM is Hypertrophic Obstructive Cardiomyopathy (HOCM). This complication is characterized by the obstructive motion of the anterior mitral leaflet causing mitral regurgitation, compromising systolic left ventricular (LV) reduced ejection fraction, and may lead to a significant outflow pressure gradients (>30 mmHg). Common treatment for HCM patients is medication, managing the symptoms. However, this treatment impairs the patient’s quality of life restricting their daily activities. Some patients who are unresponsive to medication are prone to highly invasive surgery: myectomy or ablation, exposing them to high mortality and morbidity rates. Our research is aimed at offering a new minimally invasive approach to the treatment of HOCM patients, utilizing a percutaneous device placed in the LV which locally modifies the wall structure and mitral orientation, thus reducing the outflow pressure gradient. In this study we prove the concept using numerical simulations. Models of healthy, pathological and treated LV are used as geometry for computational fluid dynamics (CFD) simulations of the time-dependent flow in the LV. The results analyses show that the suggested procedure may dramatically reduce the pressure gradients during systole and allow better flow during diastole, advising on the improvement of the current treatment and feasibility of the recommended device.