Changes of Aortic Flow Patterns detected by 4D- Flow- Magnetic Resonance Imaging after Trileaflet Reconstruction of the Aortic Valve with Autologous Pericardium compared to Prosthetic Valve Replacement with Biological Prosthesis

自体心包三叶重建主动脉瓣与生物瓣膜置换后4D流磁共振成像检测主动脉血流模式的变化

• 批准号: 421911834
• 负责人: Dr. Anatol Prinzing
• 金额: --
• 依托单位: Klinik für Herz- und Gefäßchirurgie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2020-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/421911834?language=en
• 关键词: Changes; Aortic; Flow; Patterns; detected

Trileaflet reconstruction of the aortic valve with autologous pericardium (TriRec) is a new treatment option for diseased aortic valves and offers benefits compared to conventional valve replacement. At the moment no prospective randomized trials evaluating the role of the TriRec procedure are available and factors contributing to long- term durability are unknown. In a prospective randomized trial, we want to compare aortic flow patterns using 4D- Flow- Magnetic Resonance Imaging (MRI) in patients either after the TriRec procedure or biological prosthetic valve replacement. In healthy subjects with tricuspid aortic valves, flow patterns in the ascending aorta, examined with 4D- Flow- MRI, show nearly laminar flow and no outflow obstruction. In contrast, helical flow patterns, turbulences and increased flow velocities are observed in diseased valves and also after valve replacement with mechanical or biological prostheses. These helical flow patterns seem to not only influence aortic wall remodeling but may contribute to structural valve dysfunction of biological prosthesis. We hypothesize that after the TriRec procedure flow patterns will be more physiological than after biological aortic valve replacement. The results can contribute to understanding mechanisms influencing long- term durability of the TriRec valve and help determine the role of this novel technique for the treatment of aortic valve disease.

自体心包膜三叶瓣重建术（TriRec）是一种治疗病变主动脉瓣的新方法，与传统的瓣膜置换术相比，具有许多优点。目前尚无评估TriRec手术作用的前瞻性随机试验，影响其长期耐久性的因素也未知。在一项前瞻性随机试验中，我们希望使用4D- flow -磁共振成像（MRI）比较TriRec手术或生物人工瓣膜置换术后患者的主动脉血流模式。在健康的三尖瓣主动脉瓣膜患者中，用4D- flow - MRI检查升主动脉的血流模式，显示接近层流，无流出阻塞。相反，在病变瓣膜以及机械或生物瓣膜置换术后，可以观察到螺旋流模式、湍流和流速增加。这些螺旋流动模式似乎不仅影响主动脉壁重塑，而且可能导致生物假体的结构性瓣膜功能障碍。我们假设TriRec手术后的血流模式将比生物主动脉瓣置换术后的血流模式更具生理性。该结果有助于了解影响TriRec瓣膜长期耐用性的机制，并有助于确定这种新技术在主动脉瓣疾病治疗中的作用。