A Dynamic Heart System to Facilitate the Development of Mitral Valve Repair Techniques
A Dynamic Heart System to Facilitate the Development of Mitral Valve Repair Techniques
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DOI：
10.1007/s10439-009-9653-x
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发表时间：
2009-04-01
影响因子：
3.8
通讯作者：
Buckner, Gregory D.
中科院分区：
文献类型：
--
作者：
Richards, Andrew L.;Cook, Richard C.;Buckner, Gregory D.
目的：一种新的二尖瓣修复手术工具或技术的发展可能受到成本、复杂性和进行动物试验相关时间的阻碍。为了量化二尖瓣返流和评价二尖瓣修复的质量，建立了一个动态加压模型来控制完整猪心脏的压力和流量分布。方法：设计脉冲复制系统，复制离体心脏的生理条件。为了测试该系统测量不同程度二尖瓣反流的能力，在诱导二尖瓣衰竭前后测量了8只猪心脏的两种不同压力波形的输出。四颗心脏进一步修复和测试。测量结果与超声心动图图像进行比较。结果：在所有试验中，心输出量随着左心室压力的增加而降低。诱导二尖瓣功能不全后，心输出量下降，峰值反流分数为71.8%。超声心动图清楚地显示瓣膜衰竭后的反流严重程度随着压力的增加而增加。结论：动态心脏模型一致且可靠地量化了各种严重程度的二尖瓣反流。优点包括每次试验的实验成本和时间较低，同时仍然允许在完整的心脏中进行手术评估。
Objective: The development of a novel surgical tool or technique for mitral valve repair can be hampered by cost, complexity, and time associated with performing animal trials. A dynamically pressurized model was developed to control pressure and flowrate profiles in intact porcine hearts in order to quantify mitral regurgitation and evaluate the quality of mitral valve repair. Methods: A pulse duplication system was designed to replicate physiological conditions in explanted hearts. To test the capabilities of this system in measuring varying degrees of mitral regurgitation, the output of eight porcine hearts was measured for two different pressure waveforms before and after induced mitral valve failure. Four hearts were further repaired and tested. Measurements were compared with echocardiographic images. Results: For all trials, cardiac output decreased as left ventricular pressure was increased. After induction of mitral valve insufficiencies, cardiac output decreased, with a peak regurgitant fraction of 71.8%. Echocardiography clearly showed increases in regurgitant severity from post-valve failure and with increased pressure. Conclusions: The dynamic heart model consistently and reliably quantifies mitral regurgitation across a range of severities. Advantages include low experimental cost and time associated with each trial, while still allowing for surgical evaluations in an intact heart.