Chevallier Christine, Willaert Wouter, Kawa Emilia, Centola Marcos, Steger Beat, Dirnhofer Richard, Mangin Patrice, Grabherr Silke
Department of Diagnostic and Interventional Radiology, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland; University Center of Legal Medicine Lausanne-Geneva, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland.
Clin Anat. 2014 May;27(4):556-62. doi: 10.1002/ca.22357. Epub 2013 Dec 21.
The development of new medical devices, such as aortic valves, requires numerous preliminary studies on animals and training of personnel on cadavers before the devices can be used in patients. Postmortem circulation, a technique used for postmortem angiography, allows the vascular system to be reperfused in a way similar to that in living persons. This technique is used for postmortem investigations to visualize the human vascular system and to make vascular diagnoses. Specific material for reperfusing a human body was developed recently. Our aim was to investigate whether postmortem circulation that imitates in vivo conditions allows for the testing of medical materials on cadavers. We did this by delivering an aortic valve using minimally invasive methods. Postmortem circulation was established in eight corpses to recreate an environment as close as possible to in vivo conditions. Mobile fluoroscopy and a percutaneous catheterization technique were used to deliver the material to the correct place. Once the valve was implanted, the heart and primary vessels were extracted to confirm its position. Postmortem circulation proved to be essential in several of the cadavers because it helped the clinicians to deliver the material and improve their implantation techniques. Due to the intravascular circulation, sites with substantial arteriosclerotic stenosis could be bypassed, which would have been impossible without perfusion. Although originally developed for postmortem investigations, this reperfusion technique could be useful for testing new medical devices intended for living patients.
新型医疗设备（如主动脉瓣）的研发，在用于患者之前需要在动物身上进行大量的初步研究，并对人员进行尸体培训。尸检循环是一种用于尸检血管造影的技术，它能使血管系统以类似于活体的方式重新灌注。该技术用于尸检研究，以可视化人体血管系统并进行血管诊断。最近研发出了用于人体再灌注的特定材料。我们的目的是研究模仿体内条件的尸检循环是否能在尸体上对医疗材料进行测试。我们通过微创方法输送主动脉瓣来实现这一目的。在八具尸体上建立尸检循环，以尽可能重现体内条件。使用移动荧光透视和经皮导管插入技术将材料输送到正确位置。植入瓣膜后，取出心脏和主要血管以确认其位置。尸检循环在几具尸体中被证明是必不可少的，因为它有助于临床医生输送材料并改进植入技术。由于血管内循环，可以绕过存在严重动脉硬化狭窄的部位，而没有灌注的话这是不可能的。尽管最初是为尸检研究而开发的，但这种再灌注技术可能对测试用于活体患者的新型医疗设备有用。
