Biomechanical Optimization of Cardiac Valve Repair Operations

项目总结 心脏瓣膜病是全球发病率和死亡率的重要原因。不断演变的治疗指南 尽可能支持早期干预和瓣膜修复。修复技术的进步在 临床领域主要基于解剖学和生理学前提，偶尔也基于视觉 和超声心动图表现。然而，生物力学工程的基本原理和原理 瓣膜成形术很少被研究。对这些原则的更有力的理解和 合并到外科手术中可以增强瓣膜的可维修性和耐用性，从而最终转化为 机械瓣膜长期抗凝减少血栓形成及出血后遗症 生物瓣膜恶化的置换和较低的围手术期再干预风险。我们有 设计并生产了一种新型3D打印左心模拟器，二尖瓣和主动脉瓣标本可以放入其中 在整个心脏周期中被安装和研究。可以复制多种反流性疾病状态，如 能否在目前的临床上采用修复术。创新的生物力学传感器和成像 技术促进了对这些操作中的工程原理的详细分析。比较 对当代手术技术之间显著的功能差异进行了分析和鉴定 是在使用这种心脏瓣膜系统进行的调查中发现并发表的。我们建议 深入研究体外主动脉和二尖瓣修复手术，然后在大型动物模型中验证研究结果。 我们乐观地认为，拟议中的实验将产生关于当前和潜在未来的重要知识。 它是瓣膜病的临床治疗方法，并可迅速转变为术中病人护理。

PROJECT SUMMARY Valvular heart disease is a significant cause of global morbidity and mortality. Evolving treatment guidelines support earlier intervention and valve repair when possible. Advances in repair techniques have progressed in the clinical arena primarily based upon anatomic and physiologic premises and occasionally based upon visual and echocardiographic appearance. Yet, the biomechanical engineering fundamentals and principles underlying valvuloplasty operations are rarely investigated. A more robust understanding of such principles and incorporation into surgical procedures may enhance valve reparability and durability and thus ultimately translate into less thromboembolic and hemorrhagic sequelae of long term anticoagulation for mechanical valve replacement and less perioperative risks of reintervention for bioprosthetic valve deterioration. We have designed and produced a novel 3D-printed left heart simulator into which mitral and aortic valve specimens can be mounted and studied throughout the cardiac cycle. Multiple regurgitant disease states can be reproduced, as can the current clinically-employed repair operations. Innovative biomechanical sensors and imaging technologies facilitate the detailed analysis of the engineering principles within these operations. Comparisons of and identification of notable functional differences among contemporary operative techniques have already been discovered and published from investigations performed using this heart valve system. We propose to study in depth aortic and mitral valve repair operations ex vivo and then validate findings in large animal models. We are optimistic that the proposed experiments will yield important knowledge on current and potential future clinical therapies for valve disease and can be rapidly translated to intraoperative patient care.