Using contracting band to improve right ventricle ejection fraction for patients with repaired tetralogy of Fallot: a modeling study using patient-specific CMR-based 2-layer anisotropic models of human right and left ventricles.
Using contracting band to improve right ventricle ejection fraction for patients with repaired tetralogy of Fallot: a modeling study using patient-specific CMR-based 2-layer anisotropic models of human right and left ventricles.
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DOI：
10.1016/j.jtcvs.2012.03.009
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发表时间：
2013-01
影响因子：
6
通讯作者：
del Nido, Pedro J.
中科院分区：
文献类型：
--
作者：
Yang, Chun;Tang, Dalin;Geva, Tal;Rathod, Rahul;Yamauchi, Haruo;Gooty, Vasu;Tang, Alexander;Gaudette, Glenn;Billiar, Kristen L.;Kural, Mehmet H.;del Nido, Pedro J.
法洛四联症（TOF）修复患者占晚发性右心室（RV）衰竭病例的大多数。目前的手术方法，包括肺动脉瓣置换/插入术（PVR），产生了混合的结果。提出了一种新的手术选择，在右心室放置弹性带，以改善右心室射血分数（EF）测量的心功能。基于TOF患者的心脏磁共振（CMR）成像，构建了总计20个计算RV/LV/补片/带组合模型，以研究带材料刚度变化、带长度和主动收缩的影响。这些模型包括4种不同的带材料特性，3种带长度，3种主动收缩带材料，以及用收缩组织代替补片和瘢痕的模型。我们的研究结果表明，带插入，结合主动带收缩和组织再生技术，恢复右心室心肌，有可能将右心室射血分数提高7.5%（来自最佳主动频带模型的41.63% EF超过来自基线被动频带模型的34.10% EF）和4.2%（41.63%来自最佳活性带模型，超过CMR测量的EF 37.45%）。基于CMR的RV/LV/贴片/带模型为使用弹性带改善RV心脏功能提供了“概念验证”。带插入结合心肌再生技术和RV重塑外科手术有可能改善手术后TOF修复和其他类似形式RV功能障碍患者的心室功能。进一步的研究，使用体外实验，动物模型和最终的患者研究是必要的。
Patients with repaired tetralogy of Fallot (TOF) account for the majority of cases with late onset right ventricle (RV) failure. The current surgical approach, which includes pulmonary valve replacement/insertion (PVR), has yielded mixed results. A new surgical option placing an elastic band in the right ventricle is proposed to improve RV cardiac function measured by ejection fraction (EF). A total of 20 computational RV/LV/Patch/Band combination models based on cardiac magnetic resonance (CMR) imaging from a TOF patient were constructed to investigate the impact of band material stiffness variations, band length and active contraction. These models included 4 different band material properties, 3 band length, three active contracting band materials, and models with patch and scar replaced by contracting tissues. Our results indicate that the band insertion, combined with active band contraction and tissue regeneration techniques that restore RV myocardium, has the potential to improve right ventricle ejection fraction by 7.5% (41.63% EF from the best active band model over 34.10% EF from baseline passive band model) and 4.2% (41.63% from the best active band model over CMR-measured EF 37.45%). The CMR-based RV/LV/Patch/Band model provides a “proof of concept” for using elastic bands to improve RV cardiac function. The band insertion combined with myocardium regeneration techniques and RV remodeling surgical procedures has the potential to improve ventricular function in patients with repaired TOF and other similar forms of RV dysfunction after surgery. Further investigations using in vitro experiments, animal models and final patient studies are warranted.
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影响因子：
4.7
作者：
Tang, Dalin;Yang, Chun;Geva, Tal;Gaudette, Glenn;del Nido, Pedro J.
通讯作者：
del Nido, Pedro J.
影响因子：
37.8
作者：
Geva T;Gauvreau K;Powell AJ;Cecchin F;Rhodes J;Geva J;del Nido P
通讯作者：
del Nido P
DOI：
10.1115/1.2913339
发表时间：
2008-08
期刊：
Journal of biomechanical engineering
影响因子：
--
作者：
Tang D;Yang C;Geva T;Del Nido PJ
通讯作者：
Del Nido PJ
影响因子：
2
作者：
Holzapfel, GA;Gasser, TC;Ogden, RW
通讯作者：
Ogden, RW
影响因子：
--
作者：
Kelly DJ;Rosen AB;Schuldt AJ;Kochupura PV;Doronin SV;Potapova IA;Azeloglu EU;Badylak SF;Brink PR;Cohen IS;Gaudette GR
通讯作者：
Gaudette GR