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REVIEW ARTICLE

Computer simulations in left atrial appendage occlusion: Current applications and future potential

Mingmeng Li1 ,  Yequn Chen2,3,4 ,  Zemin Cai5,6 ,  Xiangyuan Ma1 ,  Haifeng Wang1*
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1 Department of Biomedical Engineering, College of Engineering, Shantou University, Shantou, Guangdong, China
2 Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
3 Guangdong Engineering Research Centre of Human Phenome, Chemistry and Chemical Engineering Guangdong Laboratory, Human Phenome Institute of Shantou University Medical College, Shantou, Guangdong, China
4 Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
5 Department of Electronic Engineering, College of Engineering, Shantou University, Shantou, Guangdong, China
6 Intelligent Manufacturing Key Laboratory of Ministry of Education, Shantou University, Shantou, China
Brain & Heart, 025410061 https://doi.org/10.36922/BH025410061
Received: 8 October 2025 | Revised: 17 November 2025 | Accepted: 3 December 2025 | Published online: 2 January 2026
(This article belongs to the Special Issue The Brain Disorders with Left Atrium)
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Left atrial appendage (LAA) occlusion (LAAO) prevents thromboembolic stroke in patients with atrial fibrillation, particularly those unsuitable for long-term anticoagulation therapy. However, complex and variable LAA morphology challenges LAAO, including device selection and post-procedural device-related thrombosis. To address these issues, in silico/virtual optimization via computational modeling and simulation has been utilized to improve pre-procedural planning, device design, thrombosis prediction, and optimization for LAAO. This review examines the evolving landscape of LAAO, with a focus on computer modeling and simulation. We assess the capabilities, key limitations, and future potential of these computational tools through literature evaluation. These tools demonstrate clinical translatability but face limitations in simulating dynamic physiological interactions. Their broader adoption will drive personalized LAAO strategies, reduce procedural complications, and inform future research aimed at bridging the gap between virtual optimization and real-world clinical outcomes.

Keywords
Left atrial appendage occlusion
Occluders
Atrial fibrillation
Stroke
Computational modeling and simulation
Hemodynamics
Funding
This work was supported by the STU Scientific Research Initiation Grant (NTF25001T).
Conflict of interest
Haifeng Wang is the Youth Editorial Board Member of this journal, but was not in any way involved in the editorial and peer-review process conducted for this paper, directly or indirectly. Separately, other authors declared that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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