A novel 3D-Printed preferential posterior mitral annular dilation device delineates regurgitation onset threshold in an ex vivo heart simulator.
A novel 3D-Printed preferential posterior mitral annular dilation device delineates regurgitation onset threshold in an ex vivo heart simulator.
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一种新型的3D打印优先二尖瓣后环扩张装置描绘了离体心脏模拟器中的反流开始阈值。
DOI：
10.1016/j.medengphy.2020.01.005
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发表时间：
2020-03
影响因子：
2.2
通讯作者：
Woo YJ
中科院分区：
文献类型：
--
作者：
Imbrie-Moore AM;Paullin CC;Paulsen MJ;Grady F;Wang H;Hironaka CE;Farry JM;Lucian HJ;Woo YJ
由于二尖瓣环扩张引起的二尖瓣返流（MR）发生在各种二尖瓣疾病中，在许多因二尖瓣返流而心力衰竭的患者中也观察到。为了了解MR的生物力学并最终设计优化的环成形术环，需要一个具有代表性的二尖瓣环不对称扩张的疾病模型。这项工作展示了3d打印瓣膜扩张装置的设计和实现，以优先扩张二尖瓣后环。将猪二尖瓣（n = 3）缝入该装置，并安装在左心脏模拟器中，该模拟器产生生理压力并流经瓣膜，同时测量弦索力。瓣膜逐渐扩张，诱导MR，同时收集血流动力学和力数据。血流分析表明，当扩张大于25.6%的扩张阈值时，MR相对于环形扩张百分比呈线性增加（p < 0.01）。阈前，扩张未引起返流分数显著增加。在确定的阈值之前，随着扩张的增加，腱索上的力增加（p < 0.01）；阈值后，磁流变产生高度可变的力。最终，这种新型的扩张装置可以通过离体实验更准确地模拟各种MR疾病状态及其相应的修复技术。特别地，这种环形扩张装置为研究新型环形成形术环的设计和优化提供了手段。
Mitral regurgitation (MR) due to annular dilation occurs in a variety of mitral valve diseases and is observed in many patients with heart failure due to mitral regurgitation. To understand the biomechanics of MR and ultimately design an optimized annuloplasty ring, a representative disease model with asymmetric dilation of the mitral annulus is needed. This work shows the design and implementation of a 3D-printed valve dilation device to preferentially dilate the posterior mitral valve annulus. Porcine mitral valves (n = 3) were sewn into the device and mounted within a left heart simulator that generates physiologic pressures and flows through the valves, while chordal forces were measured. The valves were incrementally dilated, inducing MR, while hemodynamic and force data were collected. Flow analysis demonstrated that MR increased linearly with respect to percent annular dilation when dilation was greater than a 25.6% dilation threshold (p < 0.01). Pre-threshold, dilation did not cause significant increases in regurgitant fraction. Forces on the chordae tendineae increased as dilation increased prior to the identified threshold (p < 0.01); post-threshold, the MR resulted in highly variable forces. Ultimately, this novel dilation device can be used to more accurately model a wide range of MR disease states and their corresponding repair techniques using ex vivo experimentation. In particular, this annular dilation device provides the means to investigate the design and optimization of novel annuloplasty rings.
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DOI：
10.1016/j.jtcvs.2018.10.145
发表时间：
2019-08-01
影响因子：
6
作者：
Paulsen, Michael J.;Kasinpila, Patpilai;Woo, Y. Joseph
通讯作者：
Woo, Y. Joseph
影响因子：
3.8
作者：
Bloodworth, Charles H.;Pierce, Eric L.;Yoganathan, Ajit P.
通讯作者：
Yoganathan, Ajit P.
影响因子：
3.8
作者：
Jaworek, Michal;Lucherini, Federico;Vismara, Riccardo
通讯作者：
Vismara, Riccardo
影响因子：
6
作者：
Padala, Muralidhar;Powell, Scott N.;Croft, Laura R.;Thourani, Vinod H.;Yoganathan, Ajit P.;Adams, David H.
通讯作者：
Adams, David H.
影响因子：
37.8
作者：
He, SQ;Fontaine, AA;Levine, RA
通讯作者：
Levine, RA