■三尖瓣疾病显著影响160万美国人。三尖瓣疾病的金标准治疗是植入瓣膜成形术装置。这些环状装置有各种形状和尺寸。形状和尺寸的选择通常是由手术直觉而不是科学原理做出的。
■要了解形状和尺寸对阀门力学的影响,并为其选择提供合理的依据,我们使用特定主题的有限元模型进行了虚拟案例研究。也就是说,我们在虚拟患者中植入了6种不同尺寸的4种不同的瓣环成形术装置。每次虚拟手术后,我们计算了接合面积,小叶收缩末期角度,小叶应力,和弦力。
■我们发现轮廓装置在使收缩末期角度归一化时更好,而一个扁平的装置,爱德华兹经典,最大化接合面积,最小化小叶应力和弦力。我们进一步发现,减小设备尺寸会导致接合面积增加,但也会对收缩末期角度产生负面影响。压力,和弦力。
■根据我们对接合面积的分析,传单动议,小叶应力,和弦力,我们发现装置的形状和尺寸对阀门力学有重大影响。因此,我们的研究还证明了模拟工具和设备测试在虚拟患者中的价值。“将我们的研究扩展到更多的瓣膜,在未来,允许普遍的建议。
UNASSIGNED: Tricuspid valve disease significantly affects 1.6 million Americans. The gold standard treatment for tricuspid disease is the implantation of annuloplasty devices. These ring-like devices come in various shapes and sizes. Choices for both shape and size are most often made by surgical intuition rather than scientific rationale.
UNASSIGNED: To understand the impact of shape and size on valve mechanics and to provide a rational basis for their selection, we used a subject-specific finite element model to conduct a virtual case
study. That is, we implanted 4 different annuloplasty devices of 6 different sizes in our virtual patient. After each virtual surgery, we computed the coaptation area, leaflet end-systolic angles, leaflet stress, and chordal forces.
UNASSIGNED: We found that contoured devices are better at normalizing end-systolic angles, whereas the one flat device, the Edwards Classic, maximized the coaptation area and minimized leaflet stress and chordal forces. We further found that reducing device size led to increased coaptation area but also negatively impacted end-systolic angles, stress, and chordal forces.
UNASSIGNED: Based on our analyses of the coaptation area, leaflet motion, leaflet stress, and chordal forces, we found that device shape and size have a significant impact on valve mechanics. Thereby, our
study also demonstrates the value of simulation tools and device tests in \"virtual patients.\" Expanding our
study to many more valves may, in the future, allow for universal recommendations.