Establishment of support technology for the development of surgical training simulator

为了探讨心血管疾病外科技术的选择标准，利用模拟循环系统是有效的。本研究以二尖瓣返流为研究对象，开发手术训练模拟器。首先复制二尖瓣返流。然后应用体外模拟软件对二尖瓣成形术进行定量评价。1.二尖瓣返流的复制将新鲜的猪带乳头肌的二尖瓣置入模拟回路的二尖瓣位置。该评估系统能够通过改变瓣膜方向来模拟各种二尖瓣状况。正常模型是用乳头肌实现的，其结构与自然心脏相同。相反，脱垂模型是通过切断前缘脊索造成的。2.评价二尖瓣成形术的有效性通过对比试验，评价二尖瓣成形术修复二尖瓣前叶脱垂的有效性。为了矫正二尖瓣脱垂部分，一位经验丰富的外科医生应用了弦线置换(置换模型)和边缘到边缘技术(Edge-to-Edge Model)。应用这两种模型后，心脏的下垂部分在收缩时得到矫正，在舒张期观察到E-to-E模型的双孔区，证实了本研究开发的模拟系统可以为心脏外科医生提供有用的数据。由于数据可以量化处理，外科医生和生物医学工程师可以在科学基础上进行讨论。

In order to discuss a selection criteria for surgical technique on cardiovascular diseases, it is effective to make use of a mock circulatory system. In this study, mitral regurgitation is focused for the development of surgical training simulator. At first reproduction of mitral regurgitation was achieved. Then quantitative evaluation of the mitral valvuloplasty were performed as an application of the in vitro simulator.1.Reproduction of mitral regurgitationA fresh porcine mitral valve with chordae and papillary muscles was installed into the mitral position of the mock circuit. The evaluation system is capable of simulating various mitral conditions by changing the valve orientation. The normal model was implemented with the papillary muscle in the same configuration as in a natural heart. In contrast, the prolapse model was produced by severing anterior marginal chordae. As a result, valve closure similar to a natural heart was successfully attained in the normal model.2.Evaluation of the effectiveness of mitral valvuloplastyA comparative test was conducted to evaluate the effectiveness of mitral valvuloplasty techniques for the repair of an anterior mitral leaflet prolapse. In order to correct the prolapsed portion of mitral valve, the chordal replacement (replacement model) and the edge-to-edge technique (Edge-to-Edge model) were applied by an experienced surgeon. After the application of the two, the prolapsed portion was corrected in systole, and a double orifice area of E-to-E model was observed in diastole.In conclusion, it has been confirmed that the mock system developed in this study can provide useful data for cardiac surgeons. As the data can be treated quantitatively, surgeons and biomedical engineers can discuss on the scientific basis.