Patient-specific MRI-based 3D FSI RV/LV/patch models for pulmonary valve replacement surgery and patch optimization.
Patient-specific MRI-based 3D FSI RV/LV/patch models for pulmonary valve replacement surgery and patch optimization.
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DOI：
10.1115/1.2913339
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发表时间：
2008-08
期刊：
影响因子：
--
通讯作者：
Del Nido PJ
中科院分区：
文献类型：
--
作者：
Tang D;Yang C;Geva T;Del Nido PJ
为评价和优化人类肺动脉瓣置换/植入术（PVR）手术过程和补片设计，引入了一种具有流体-结构相互作用（FSI）的患者特异性右/左心室和补片（RV/LV/补片）组合模型。进行心脏磁共振（CMR）成像研究，以获取健康志愿者和需要RV重塑和PVR的患者在计划手术前后的心室几何形状、流速和流速。建立了基于CMR的RV/LV/补片FSI模型，进行力学分析并评估RV心脏功能。术前和术后CMR数据均用于调整和验证模型，使预测的RV体积与CMR测量值达到良好的一致性（误差<3%）。根据术前数据制作了两种RV/LV/补片模型，以评价和比较两种PVR手术：（i）传统补片，很少或不修剪瘢痕组织;（ii）小补片，积极修剪瘢痕并减少RV体积。我们的建模结果表明：（a）基于患者特定CMR的计算建模可以提供RV心脏功能的准确评估，（B）使用较小补片和更积极的瘢痕去除的PVR可降低补片区域的应力/应变条件，并可能改善RV功能的恢复。需要更多的患者研究来验证我们的发现。
A patient-specific right/left ventricle and patch (RV/LV/patch) combination model with fluid-structure interactions (FSIs) was introduced to evaluate and optimize human pulmonary valve replacement/insertion (PVR) surgical procedure and patch design. Cardiac magnetic resonance (CMR) imaging studies were performed to acquire ventricle geometry, flow velocity, and flow rate for healthy volunteers and patients needing RV remodeling and PVR before and after scheduled surgeries. CMR-based RV/LV/patch FSI models were constructed to perform mechanical analysis and assess RV cardiac functions. Both pre- and postoperation CMR data were used to adjust and validate the model so that predicted RV volumes reached good agreement with CMR measurements (error <3%). Two RV/LV/patch models were made based on preoperation data to evaluate and compare two PVR surgical procedures: (i) conventional patch with little or no scar tissue trimming, and (ii) small patch with aggressive scar trimming and RV volume reduction. Our modeling results indicated that (a) patient-specific CMR-based computational modeling can provide accurate assessment of RV cardiac functions, and (b) PVR with a smaller patch and more aggressive scar removal led to reduced stress/strain conditions in the patch area and may lead to improved recovery of RV functions. More patient studies are needed to validate our findings.
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