Dasi Lakshmi P, Hatoum Hoda, Kheradvar Arash, Zareian Ramin, Alavi S Hamed, Sun Wei, Martin Caitlin, Pham Thuy, Wang Qian, Midha Prem A, Raghav Vrishank, Yoganathan Ajit P
Department of Biomedical Engineering, Dorothy Davis Heart and Lung Research Institute, The Ohio State University, 473 W 12th Avenue, Columbus, OH, 43210, USA.
The Edwards Lifesciences Center for Advanced Cardiovascular Technology, Department of Biomedical Engineering, University of California, Irvine, CA, 92697, USA.
Ann Biomed Eng. 2017 Feb;45(2):310-331. doi: 10.1007/s10439-016-1759-3. Epub 2016 Nov 21.
Transcatheter aortic valves (TAVs) represent the latest advances in prosthetic heart valve technology. TAVs are truly transformational as they bring the benefit of heart valve replacement to patients that would otherwise not be operated on. Nevertheless, like any new device technology, the high expectations are dampened with growing concerns arising from frequent complications that develop in patients, indicating that the technology is far from being mature. Some of the most common complications that plague current TAV devices include malpositioning, crimp-induced leaflet damage, paravalvular leak, thrombosis, conduction abnormalities and prosthesis-patient mismatch. In this article, we provide an in-depth review of the current state-of-the-art pertaining the mechanics of TAVs while highlighting various studies guiding clinicians, regulatory agencies, and next-generation device designers.
经导管主动脉瓣(TAV)代表了人工心脏瓣膜技术的最新进展。TAV具有真正的变革性,因为它们为那些原本无法接受手术的患者带来了心脏瓣膜置换的益处。然而,与任何新设备技术一样,随着患者频繁出现并发症引发的担忧日益增加,人们对其的高期望有所降低,这表明该技术远未成熟。困扰当前TAV设备的一些最常见并发症包括位置不当、压接导致的瓣叶损伤、瓣周漏、血栓形成、传导异常以及假体-患者不匹配。在本文中,我们对TAV的力学相关的当前技术水平进行了深入综述,同时重点介绍了指导临床医生、监管机构和下一代设备设计师的各种研究。