Young Melissa, Erdemir Ahmet, Stucke Samantha, Klatte Ryan, Davis Brian, Navia Jose L
Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195, USA ; Medical Device Solutions (MDS) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
J Med Device. 2012 Sep;6(3):31005-31012. doi: 10.1115/1.4007182.
In certain populations, open heart surgery to replace a diseased mitral valve is not an option, leaving percutaneous delivery a viable alternative. However, a surgical transcatheter based delivery of a metallic support frame incorporating a tissue derived valve puts considerable constraints on device specifications. Expansion to a large diameter from the catheter diameter without mechanical fracture involves advanced device design and appropriate material processing and selection. In this study, a new frame concept is presented with a desirable feature that incorporates wings that protrude during expansion to establish adequate fixation. Expansion characteristics of the design in relation to annulus fixation were quantified through finite element analysis predictions of the frame wing span and angles. Computational modeling and simulation was used to identify many favorable design features for the transcatheter mitral valve frame and obtain desired expansion diameters (35-45mm), acceptable radial stiffness (2.7N/mm), and ensure limited risk of failure based on predicted plastic deformations.
在某些人群中,通过开胸手术置换病变二尖瓣并非可行选择,经皮递送便成为一种可行的替代方案。然而,基于外科手术的经导管递送包含组织衍生瓣膜的金属支撑框架,对设备规格施加了相当大的限制。在不发生机械断裂的情况下从导管直径扩展到较大直径,需要先进的设备设计以及适当的材料加工和选择。在本研究中,提出了一种新的框架概念,其具有一个理想特性,即包含在扩张过程中突出以实现充分固定的翼片。通过对框架翼展和角度的有限元分析预测,量化了该设计相对于瓣环固定的扩张特性。使用计算建模和模拟来确定经导管二尖瓣框架的许多有利设计特征,并获得所需的扩张直径(35 - 45毫米)、可接受的径向刚度(2.7牛/毫米),并基于预测的塑性变形确保有限的失效风险。