Invention of a novel three-dimensional virtual and realistic model of the mitral complex by using three-dimensional echocardiography

环成形术目前是缺血性/功能性磁共振的常用手术策略，即使环成形术后磁共振仍然存在。最近，新的手术策略有望减少环成形术后慢性持续性缺血性MR。然而，在临床上，尽管弯曲的二尖瓣和鞍状的二尖瓣环结构独特，但在二维超声心动图中，二尖瓣小叶和二尖瓣环的几何变化程度以前是在单片二尖瓣成分中评估的。因此，目前在临床研究中用于测量帐篷长度（覆盖长度）或帐篷面积的二维成像平面可能会遗漏最大系索部位。此外，目前的手术方法是基于动物实验的有益结果而开发的，忽略了临床环境中每个患者的各种三维几何畸形。在临床上，成功的瓣膜修复需要更多的二尖瓣小叶和瓣环。我们开发了一个原创的软件系统，可以提供二尖瓣小叶和二尖瓣环的三维几何形状，明确二尖瓣小叶的最大支索位置，量化人类二尖瓣支索和二尖瓣环畸形的程度。这将有助于外科医生了解缺血性MR的确切机制，并对每个个体的手术策略做出正确的决定。在本项目中，我们制作了一个原创的软件系统来创建二尖瓣复合体的三维图像，并研究了三维评估的临床应用。在临床和实验研究中，我们证明了由重建的虚拟三维图像得出的三维适应指数是评估功能性二尖瓣反流机制的一个有用参数。此外，我们成功地利用3D数据集制作了二尖瓣复合体的真实模型，这使我们能够在手术前检查二尖瓣部件的复杂形状。少

Annuloplasty is currently a common surgical strategy for ischemic/functional MR, even if MR often persists after annuloplasty. Recently, new surgical strategies have been expected to reduce chronic persistent ischemic MR after annuloplasty. However, in the clinical setting, the degree of geometric changes of the mitral leaflets and annulus has previously assessed in a single slice of the mitral valve component by 2-D echocardiography, in spite of the unique configuration of the curved mitral valve and saddle-shaped mitral annulus. Hence, 2-D imaging plane that is currently used for the measurement of tenting length (coaptation length) or tenting area in the clinical studies may miss the maximum tethering site. Besides, present surgical approaches have been developed based on the beneficial result from animal experiments ignoring the various 3-D geometric deformities in each patient in the clinical setting. Precise and comprehensive understanding of the 3-D geometric change of the whole … More mitral leaflets and annulus is needed for successful valve repair in the clinical setting. We have developed a original software system which can provide 3-D geometry of the mitral leaflets and annulus, clarify the maximum tenting site of the mitral leaflet, and quantify the degree of mitral valve tenting and annular deformity in humans. It will be helpful for surgeon to know the precise mechanisms of the ischemic MR and to make a proper decision for the surgical strategy in each individual.In the present project, we made an original software system to create a 3D images of the mitral valve complex, and examine the clinical utility of the 3D assessment. In clinical and experimental studies, we demonstrated that the 3D coaptation index derived by the reconstructed virtual 3D images was a useful parameter that is a key to assess the mechanisms of functional mitral regurgitation. Furthermore, we succeeded to make a real model of the mitral complex by utilizing the 3D dataset, which allows us to examine the complicated shape of the mitral valve components before surgery. Less