Novel bicuspid aortic valve model with aortic regurgitation for hemodynamic status analysis using an ex vivo simulator.
Novel bicuspid aortic valve model with aortic regurgitation for hemodynamic status analysis using an ex vivo simulator.
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DOI：
10.1016/j.jtcvs.2020.06.028
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Woo YJ
中科院分区：
文献类型：
--
作者：
Zhu Y;Imbrie-Moore AM;Paulsen MJ;Priromprintr B;Wang H;Lucian HJ;Farry JM;Woo YJ
目的是设计和评价一种临床相关的新型离体二叶式主动脉瓣模型，该模型模拟最常见的人类表型与主动脉瓣返流相关。三个牛主动脉瓣不对称地安装在先前验证的3D打印左心脏模拟器中。将非右连合和非左连合均向左右连合轻微移位，并将左冠状动脉瓣尖和右冠状动脉瓣尖缝合在一起。然后分离左右连合，并在低于其原生高度10 mm处重新植入。游离缘缩短用于瓣膜修复。在修复前后收集血流动力学、高速摄像和超声心动图数据。二叶式主动脉瓣模型制作成功。高速摄像证实了基线二尖瓣主动脉瓣模型的融合瓣尖脱垂。血流动力学和压力数据证实了模拟生理疾病条件下的主动脉瓣返流和随后的修复成功。与基线相比，修复后的瑞格列汀分数显著降低（28.6±3.4% vs 14.5± 4.4%，p= 0.037）。修复前与修复后瓣膜的峰值速度、峰值压差或平均压差无变化：分别为292± 18.3 cm/s与325.3± 58.2 cm/s（p= 0.29）、34.3± 4.2 mmHg与43.3± 15.4 mmHg（p= 0.30）和11± 1 mmHg与9.3±2.5 mmHg（p= 0.34）。成功设计了离体二叶主动脉瓣模型，并重现了最常见的人类主动脉瓣返流表型。这些瓣膜均成功修复，证实了其评价瓣膜血流动力学和优化二叶式主动脉瓣手术修复的潜力。一个双叶主动脉瓣模型概括了最常见的人类表型，为修复分析提供了一个关键途径。
The objective was to design and evaluate a clinically relevant, novel ex vivo bicuspid aortic valve model that mimics the most common human phenotype with associated aortic regurgitation. Three bovine aortic valves were mounted asymmetrically in a previously validated 3D-printed left heart simulator. The non-right commissure and the non-left commissure were both shifted slightly towards the left-right commissure, and the left and right coronary cusps were sewn together. The left-right commissure was then detached and re-implanted 10 mm lower than its native height. Free margin shortening was used for valve repair. Hemodynamics, high-speed videography, and echocardiography data were collected before and after the repair. The bicuspid aortic valve model was successfully produced and repaired. High-speed videography confirmed prolapse of the fused cusp of the baseline bicuspid aortic valve models in diastole. Hemodynamics and pressure data confirmed simulation of physiologic diseased conditions with aortic regurgitation and the subsequent success of repair. Regurgitant fraction post-repair was significantly reduced compared to that at baseline (28.6±3.4% versus 14.5±4.4%, p=.037). There was no change in peak velocity, peak gradient, or mean gradient across the valve pre- vs. post-repair: 292±18.3cm/s versus 325.3±58.2cm/s (p=.29), 34.3±4.2mmHg versus 43.3±15.4mmHg (p=.30), and 11±1mmHg versus 9.3±2.5 mmHg (p=.34), respectively. An ex vivo bicuspid aortic valve model was successfully designed and recapitulated the most common human phenotype with aortic regurgitation. These valves were successfully repaired, confirming its potential for evaluating valve hemodynamics and optimizing surgical repair for bicuspid aortic valves. A regurgitant bicuspid aortic valve model recapitulates the most common human phenotype, providing a key avenue for repair analysis.
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DOI：
10.1016/j.jtcvs.2009.11.058
发表时间：
2010-08-01
影响因子：
6
作者：
Boodhwani, Munir;de Kerchove, Laurent;El Khoury, Gebrine
通讯作者：
El Khoury, Gebrine
影响因子：
3.4
作者：
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通讯作者：
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DOI：
10.1016/j.jtcvs.2011.08.021
发表时间：
2011-12-01
影响因子：
6
作者：
de Kerchove, Laurent;Boodhwani, Munir;El Khoury, Gebrine
通讯作者：
El Khoury, Gebrine
DOI：
10.1016/j.jtcvs.2014.05.021
发表时间：
2014-12-01
影响因子：
6
作者：
Gleason, Thomas G.
通讯作者：
Gleason, Thomas G.
影响因子：
2.4
作者：
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通讯作者：
Kuang, ZB