A novel finite element-based patient-specific mitral valve repair: virtual ring annuloplasty.
A novel finite element-based patient-specific mitral valve repair: virtual ring annuloplasty.
复制标题
一种新型有限元的患者特异性二尖瓣修复：虚拟环形成形术。
DOI：
10.3233/bme-130816
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发表时间：
2014
影响因子：
1
通讯作者：
Kim H
中科院分区：
文献类型：
--
作者：
Choi A;Rim Y;Mun JS;Kim H
正常二尖瓣（MV）功能的改变导致二尖瓣关闭不全，即，二尖瓣返流（MR）。二尖瓣修复术是MR治疗中最常用和最有效的手术干预。在复杂的二尖瓣重建修复后植入瓣膜成形环，以防止潜在的二尖瓣返流复发。我们开发了一种基于有限元（FE）的新型模拟方案，以按照标准临床指南程序进行患者特定的虚拟环瓣膜成形术。使用二尖瓣环扩张患者的3D超声心动图数据创建虚拟MV。考虑到MV装置的几何形状，确定了环的适当类型和尺寸。将瓣膜成型环定位在患者二尖瓣模型上，并模拟瓣膜成形术。对整个心动周期的MV功能进行动态模拟。虚拟患者特定瓣膜成形术模拟很好地显示了瓣膜成型环植入前后MV装置的形态信息。与瓣环成形术前相比，瓣环成形术后MV功能的动态模拟显示MV瓣叶和瓣环上的应力分布显著降低，瓣叶对合恢复。这种新型的基于FE的患者特异性MV修复模拟技术提供了瓣环成形术后功能改善的定量信息。虚拟二尖瓣修复策略可以有效地评估和预测二尖瓣病变的介入治疗。
Alterations of normal mitral valve (MV) function lead to mitral insufficiency, i.e., mitral regurgitation (MR). Mitral repair is the most popular and most efficient surgical intervention for MR treatment. An annuloplasty ring is implanted following complex reconstructive MV repairs to prevent potential reoccurrence of MR. We have developed a novel finite element (FE)-based simulation protocol to perform patient-specific virtual ring annuloplasty following the standard clinical guideline procedure. A virtual MV was created using 3D echocardiographic data in a patient with mitral annular dilation. Proper type and size of the ring were determined in consideration of the MV apparatus geometry. The ring was positioned over the patient MV model and annuloplasty was simulated. Dynamic simulation of MV function across the complete cardiac cycle was performed. Virtual patient-specific annuloplasty simulation well demonstrated morphologic information of the MV apparatus before and after ring implantation. Dynamic simulation of MV function following ring annuloplasty demonstrated markedly reduced stress distribution across the MV leaflets and annulus as well as restored leaflet coaptation compared to pre-annuloplasty. This novel FE-based patient-specific MV repair simulation technique provides quantitative information of functional improvement following ring annuloplasty. Virtual MV repair strategy may effectively evaluate and predict interventional treatment for MV pathology.