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

瓣环成形术目前是缺血性/功能性二尖瓣返流的常用手术策略，即使二尖瓣返流通常在瓣环成形术后持续存在。最近，新的手术策略有望减少瓣环成形术后的慢性持续性缺血性二尖瓣返流。然而，在临床环境中，尽管弯曲的二尖瓣和鞍形二尖瓣环具有独特的构型，但之前已通过2-D超声心动图在二尖瓣组件的单个切片中评估了二尖瓣瓣叶和瓣环的几何变化程度。因此，临床研究中目前用于测量帐篷长度（接合长度）或帐篷面积的2-D成像平面可能会错过最大栓系部位。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。准确全面地理解整体的三维几何变化 ...更多信息 二尖瓣小叶和瓣环是在临床环境中成功进行瓣膜修复所必需的。我们开发了一个原始的软件系统，可以提供二尖瓣瓣叶和瓣环的三维几何形状，澄清二尖瓣瓣叶的最大帐篷部位，并量化人类二尖瓣帐篷和瓣环畸形的程度。本课题利用自主开发的软件系统，对二尖瓣复合体进行三维重建，并对三维重建的临床应用价值进行研究。在临床和实验研究中，我们证明了由重建的虚拟3D图像导出的3D接合指数是一个有用的参数，是评估功能性二尖瓣返流机制的关键。此外，我们成功地通过利用3D数据集制作了二尖瓣复合体的真实的模型，这使我们能够在手术前检查二尖瓣组件的复杂形状。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