Biomechanical engineering analysis of an acute papillary muscle rupture disease model using an innovative 3D-printed left heart simulator.
Biomechanical engineering analysis of an acute papillary muscle rupture disease model using an innovative 3D-printed left heart simulator.
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使用创新的3D打印左心模拟器的急性乳头肌肉破裂疾病模型的生物力学工程分析。
DOI：
10.1093/icvts/ivab373
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发表时间：
2022-05-02
影响因子：
--
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中科院分区：
文献类型：
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急性乳头肌 (PM) 破裂的严重程度根据破裂的程度和部位而异。然而，不同破裂变化对血液动力学的影响仍然知之甚少。使用新型离体模型，我们试图研究急性 PM 破裂，以改善临床管理。使用安装在离体左心模拟器内的猪二尖瓣（n = 32）来模拟PM破裂。根据 PM 头将二尖瓣分为象限进行分析。通过从感兴趣的 1 PM 头部产生的腱索总数的 1/3 逐渐切割来模拟急性 PM 破裂。测量血液动力学参数。 1 个特定 PM 头部的腱索断裂 >2/3 或反流率 >60% 导致血流动力学明显恶化。前外侧 PM 的破裂对血流动力学的负面影响比后内侧 PM 的破裂更强。发生在前外侧 PM 前头部的破裂比发生在其他 PM 头部的破裂导致更明显的血流动力学不稳定。急性 PM 破裂对血流动力学的影响根据破裂的部位和程度而有很大差异。从 1 PM 头部起≤2/3 的腱索断裂或在后内侧 PM 处断裂会导致不太明显的血流动力学影响，表明耐受手术的可能性更高。 PM 前外侧（特别是前头）的破裂、1 PM 头超过 2/3 的腱索破裂或反流分数 > 60% 会导致明显的血流动力学不稳定，表明手术前桥接策略的潜在益处。急性乳头肌（PM）破裂是一种机械并发症，可导致严重的二尖瓣关闭不全（MR）、心源性休克（CS）和急性肺水肿[1]。
The severity of acute papillary muscle (PM) rupture varies according to the extent and site of the rupture. However, the haemodynamic effects of different rupture variations are still poorly understood. Using a novel ex vivo model, we sought to study acute PM rupture to improve clinical management. Using porcine mitral valves (n = 32) mounted within an ex vivo left heart simulator, PM rupture was simulated. The mitral valve was divided into quadrants for analysis according to the PM heads. Acute PM rupture was simulated by incrementally cutting from 1/3 to the total number of chordae arising from 1 PM head of interest. Haemodynamic parameters were measured. Rupture >2/3 of the chordae from 1 given PM head or regurgitation fraction >60% led to markedly deteriorated haemodynamics. Rupture at the anterolateral PM had a stronger negative effect on haemodynamics than rupture at the posteromedial PM. Rupture occurring at the anterior head of the anterolateral PM led to more marked haemodynamic instability than rupture occurring at the other PM heads. The haemodynamic effects of acute PM rupture vary considerably according to the site and extent of the rupture. Rupture of ≤2/3 of chordae from 1 PM head or rupture at the posteromedial PM lead to less marked haemodynamics effects, suggesting a higher likelihood of tolerating surgery. Rupture at the anterolateral PM, specifically the anterior head, rupture of >2/3 of chordae from 1 PM head or regurgitation fraction >60% led to marked haemodynamic instability, suggesting the potential benefit from bridging strategies prior to surgery. Acute papillary muscle (PM) rupture is a mechanical complication that leads to severe mitral regurgitation (MR), cardiogenic shock (CS) and acute pulmonary oedema [1].
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影响因子：
1.8
作者：
Hoenig, JM;Heisey, DM
通讯作者：
Heisey, DM
影响因子：
37.8
作者：
Russo, Antonio;Suri, Rakesh M.;Enriquez-Sarano, Maurice
通讯作者：
Enriquez-Sarano, Maurice
DOI：
10.1093/ejcts/ezy169
发表时间：
2018-07-01
期刊：
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
影响因子：
--
作者：
Hickey GL;Grant SW;Dunning J;Siepe M
通讯作者：
Siepe M
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：
4.2
作者：
Pahuja, Mohit;Ranka, Sagar;Burkhoff, Daniel
通讯作者：
Burkhoff, Daniel