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经导管主动脉瓣膜植入术(TAVI)患者特异性术后结局的预测:定位策略对瓣膜性能的影响。

Prediction of patient-specific post-operative outcomes of TAVI procedure: The impact of the positioning strategy on valve performance.

作者信息

Morganti S, Brambilla N, Petronio A S, Reali A, Bedogni F, Auricchio F

机构信息

Dip. di Ingegneria Industriale e dell׳Informazione, Università di Pavia, Pavia, Italy.

ICSA Policlinico Sant׳Ambrogio, Milano, Italy.

出版信息

J Biomech. 2016 Aug 16;49(12):2513-9. doi: 10.1016/j.jbiomech.2015.10.048. Epub 2015 Dec 23.

Abstract

Prosthesis positioning in transcatheter aortic valve implantation procedures represents a crucial aspect for procedure success as demonstrated by many recent studies on this topic. Possible complications, device performance, and, consequently, also long-term durability are highly affected by the adopted prosthesis placement strategy. In the present work, we develop a computational finite element model able to predict device-specific and patient-specific replacement procedure outcomes, which may help medical operators to plan and choose the optimal implantation strategy. We focus in particular on the effects of prosthesis implantation depth and release angle. We start from a real clinical case undergoing Corevalve self-expanding device implantation. Our study confirms the crucial role of positioning in determining valve anchoring, replacement failure due to intra or para-valvular regurgitation, and post-operative device deformation.

摘要

经导管主动脉瓣植入手术中的假体定位是手术成功的关键因素,许多近期关于该主题的研究都证明了这一点。所采用的假体放置策略会对可能出现的并发症、器械性能以及长期耐用性产生重大影响。在本研究中,我们开发了一种计算有限元模型,该模型能够预测特定器械和特定患者的置换手术结果,这可能有助于医疗操作人员规划并选择最佳植入策略。我们特别关注假体植入深度和释放角度的影响。我们从一个正在接受Corevalve自膨胀装置植入的真实临床病例入手。我们的研究证实了定位在确定瓣膜锚定、因瓣内或瓣周反流导致的置换失败以及术后器械变形方面的关键作用。

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