Development of a stent-biovalve with round-shaped leaflets: in vitro hydrodynamic evaluation for transcatheter pulmonary valve implantation (TPVI).
Development of a stent-biovalve with round-shaped leaflets: in vitro hydrodynamic evaluation for transcatheter pulmonary valve implantation (TPVI).
复制标题
具有圆形小叶的支架生物瓣膜的开发：经导管肺动脉瓣植入（TPVI）的体外流体动力学评估。
DOI：
10.1007/s10047-016-0909-6
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发表时间：
2016
期刊：
影响因子：
1.3
通讯作者：
Tatsumi E.
中科院分区：
文献类型：
--
作者：
Sumikura H;Nakayama Y;Ohnuma K;Takewa Y;Tatsumi E.
本研究评价了一种新设计的自体心脏瓣膜形组织与支架[支架-生物瓣膜（SBV）]，用于使用“体内组织架构”技术进行经导管肺动脉瓣植入。在先前开发的具有扁平形状瓣叶的SBV（FS-SBV）中，瓣膜不能快速闭合，因为瓣叶固定在打开位置，这在闭合阶段引起了容积的增加。因此，一种新型的模具，以制造SBV与圆形瓣叶（RS-SBV），并与不同的瓣膜直径的流体动力学性能进行了评价，在这项研究中。将一种特殊设计的、自膨胀的、支架安装的、丙烯酸模具（具有3个半球）放置在山羊背侧皮下袋中2个月。浸提后，从植入物上取下丙烯酸模具，并获得浸有支架支柱的管状组织。半管状组织的3个半球完全向内对折。设计丙烯酸模具，使得管状组织的折叠的一半变成圆形瓣叶。将3个连合部分连接形成3个瓣叶，从而制备RS-SBV（内径25 mm）。在肺循环条件下，在脉动模拟循环回路中，RS-SBV比FS-SBV关闭更快。RS-SBV的抗肿瘤分数约为6%，低于FS-SBV。根据压力差和有效瓣口面积，RS-SBV的合适肺动脉瓣环直径为24 ~ 25 mm。
This study evaluates a newly designed autologous heart valve-shaped tissue with a stent [stent-biovalve (SBV)] for transcatheter pulmonary valve implantation using the “in-body tissue architecture” technology. In the previously developed SBV with flat-shaped leaflets (FS-SBV), the valve could not close rapidly, because the leaflets were fixed in the open position, which induced regurgitant volume in the closing phase. Therefore, a novel mold to fabricate an SBV with round-shaped leaflets (RS-SBV) was developed, and its hydrodynamic performance with different valve diameters was evaluated in this study. A specially designed, self-expandable, stent-mounted, acrylic mold, which has 3 hemispheres, was placed in dorsal subcutaneous pouches of goats for 2 months. After extraction, the acrylic mold was removed from the implant, and a tubular tissue impregnated with the stent strut was obtained. Half of the tubular tissue with 3 hemispheres was completely folded in half inwards. The acrylic mold was designed, such that the folded half of the tubular tissue became the round-shaped leaflets. The 3 commissure parts were connected to form 3 leaflets, resulting in the preparation of the RS-SBV (internal diameter 25 mm). The RS-SBV closed more rapidly than the FS-SBV in a pulsatile mock circulation circuit under the pulmonary circulation conditions. The regurgitant fraction of the RS-SBV was approximately 6 %, which was lower than that of the FS-SBV. The appropriate pulmonary annulus diameter of the RS-SBV was from 24 to 25 mm based on the pressure difference and effective orifice area.