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本文引用的文献

1
Material properties of CorCap passive cardiac support device.CorCap 被动心脏支持装置的材料性能。
Ann Thorac Surg. 2013 Jan;95(1):148-54. doi: 10.1016/j.athoracsur.2012.07.036. Epub 2012 Sep 13.
2
A coupled biventricular finite element and lumped-parameter circulatory system model of heart failure.心力衰竭的双心室耦合有限元与集总参数循环系统模型。
Comput Methods Biomech Biomed Engin. 2013;16(8):807-18. doi: 10.1080/10255842.2011.641121. Epub 2012 Jan 16.
3
Beneficial effects of the CorCap cardiac support device: five-year results from the Acorn Trial.CorCap 心脏支持装置的有益效果:Acorn 试验的五年结果。
J Thorac Cardiovasc Surg. 2012 May;143(5):1036-42. doi: 10.1016/j.jtcvs.2011.06.014. Epub 2011 Jul 16.
4
Effect of adjustable passive constraint on the failing left ventricle: a finite-element model study.可调式被动约束对衰竭左心室的影响:有限元模型研究。
Ann Thorac Surg. 2010 Jan;89(1):132-7. doi: 10.1016/j.athoracsur.2009.08.075.
5
A computationally efficient formal optimization of regional myocardial contractility in a sheep with left ventricular aneurysm.对一只患有左心室动脉瘤的绵羊的局部心肌收缩性进行计算高效的形式优化。
J Biomech Eng. 2009 Nov;131(11):111001. doi: 10.1115/1.3148464.
6
Sustained benefits of the CorCap Cardiac Support Device on left ventricular remodeling: three year follow-up results from the Acorn clinical trial.CorCap心脏支持装置对左心室重构的持续益处:橡果临床试验的三年随访结果。
Ann Thorac Surg. 2007 Oct;84(4):1236-42. doi: 10.1016/j.athoracsur.2007.03.096.
7
Clinical evaluation of the CorCap Cardiac Support Device in patients with dilated cardiomyopathy.CorCap心脏支持装置在扩张型心肌病患者中的临床评估。
Ann Thorac Surg. 2007 Oct;84(4):1226-35. doi: 10.1016/j.athoracsur.2007.03.095.
8
Cardiotropin-1 and myocardial strain change heterogeneously in cardiomyopathy.
J Surg Res. 2007 Aug;141(2):277-83. doi: 10.1016/j.jss.2006.12.539. Epub 2007 Jun 14.
9
Surgical ventricular remodeling: a balancing act on systolic and diastolic properties.外科心室重塑:收缩和舒张特性的平衡行为。
J Thorac Cardiovasc Surg. 2006 Sep;132(3):459-63. doi: 10.1016/j.jtcvs.2006.04.045.
10
Experimental and clinical studies with the Paracor cardiac restraint device.使用Paracor心脏约束装置的实验和临床研究。
Semin Thorac Cardiovasc Surg. 2005 Winter;17(4):364-8. doi: 10.1053/j.semtcvs.2005.09.006.

阿库恩(Acorn)穹顶型心包补片心脏支撑装置在衰竭心脏的双心室有限元建模。

Biventricular finite element modeling of the Acorn CorCap Cardiac Support Device on a failing heart.

机构信息

Department of Mechanical Engineering, University of Kentucky, Lexington, Kentucky, USA.

出版信息

Ann Thorac Surg. 2013 Jun;95(6):2022-7. doi: 10.1016/j.athoracsur.2013.02.032. Epub 2013 May 2.

DOI:10.1016/j.athoracsur.2013.02.032
PMID:23643546
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3702266/
Abstract

BACKGROUND

The Acorn CorCap Cardiac Support Device (CSD; Acorn Cardiovascular Inc, St. Paul, MN) is a woven polyester jacket that is placed around the heart and designed to reverse the progressive remodeling associated with dilated cardiomyopathy. However, the effects of the Acorn CSD on myofiber stress and ventricular function remain unknown. We tested the hypothesis that the Acorn CSD reduces end-diastolic (ED) myofiber stress.

METHODS

A previously described weakly coupled biventricular finite element (FE) model and circulatory model based on magnetic resonance images of a dog with dilated cardiomyopathy was used. Virtual applications of the CSD alone (Acorn), CSD with rotated fabric fiber orientation (rotated), CSD with 5% prestretch (tight), and CSD wrapped only around the left ventricle (LV; LV-only) were performed, and the effect on myofiber stress at ED and pump function was calculated.

RESULTS

The Acorn CSD has a large effect on ED myofiber stress in the LV free wall, with reductions of 55%, 79%, 92%, and 40% in the Acorn, rotated, tight, and LV-only cases, respectively. However, there is a tradeoff in which the Acorn CSD reduces stroke volume at LV end-diastolic pressure of 8 mm Hg by 23%, 25%, 30%, and 7%, respectively, in the Acorn, rotated, tight, and LV-only cases.

CONCLUSIONS

The Acorn CSD significantly reduces ED myofiber stress. However, CSD wrapped only around the LV was the only case with minimal negative effect on pump function. Findings suggest that LV-only CSD and Acorn fabric orientation should be optimized to allow maximal myofiber stress reduction with minimal reduction in pump function.

摘要

背景

Acorn CorCap 心脏支持装置(CSD;Acorn Cardiovascular Inc,明尼苏达州圣保罗)是一种环绕心脏的编织聚酯套,旨在逆转与扩张型心肌病相关的进行性重塑。然而,Acorn CSD 对心肌纤维压力和心室功能的影响尚不清楚。我们检验了 Acorn CSD 降低舒张末期(ED)心肌纤维压力的假设。

方法

使用先前描述的弱耦合双心室有限元(FE)模型和基于患有扩张型心肌病的狗的磁共振成像的循环模型。单独应用 CSD(Acorn)、纤维取向旋转的 CSD(旋转)、预拉伸 5%的 CSD(紧绷)和仅包裹左心室(LV;LV 仅)的 CSD 的虚拟应用,计算 ED 时心肌纤维压力和泵功能的变化。

结果

Acorn CSD 对 LV 游离壁 ED 心肌纤维压力有很大影响,Acorn、旋转、紧绷和 LV 仅的情况分别减少了 55%、79%、92%和 40%。然而,存在一个权衡,即 Acorn CSD 以 8 mmHg 的 LV 舒张末期压力分别减少 23%、25%、30%和 7%的每搏量。

结论

Acorn CSD 显著降低 ED 心肌纤维压力。然而,仅包裹 LV 的 CSD 是对泵功能影响最小的唯一情况。结果表明,LV 仅 CSD 和 Acorn 织物取向应进行优化,以允许最大程度地减少心肌纤维压力,同时最小化泵功能的降低。