Shirakawa Takashi, Yoshitatsu Masao, Koyama Yasushi, Kurata Akira, Miyoshi Toru, Mizoguchi Hiroki, Masai Takafumi, Toda Koichi, Sawa Yoshiki
Department of Cardiovascular Surgery, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan.
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
J Artif Organs. 2018 Sep;21(3):348-355. doi: 10.1007/s10047-018-1033-6. Epub 2018 Mar 19.
Determining the complex geometry of mitral valve prolapse is often difficult. We constructed 3D models of six prolapsed mitral valves for surgical assessment, and evaluated how accurately the models could replicate individual valve dimensions. 3D polygon data were constructed based on an original segmentation method for computed tomography images. The model's replication performance was confirmed via dimensional comparison between the actual hearts during surgery and those models. The results revealed that the prolapsed segments matched in all cases; however, torn chordae were replicated in four cases. The mean height differences were 0.0 mm (SD 1.6, range - 2 to + 2 mm) for the anterolateral side, 0.0 mm (SD 1.7, range - 2 to + 2 mm) for the prolapsed leaflet center, and - 1.5 mm (SD 0.6, range - 1 to - 2 mm) for the posteromedial side. Regression analysis showed a strong and positive correlation, and Bland-Altman plots indicated quantitative similarity of the models to the actual hearts. We concluded that our 3D valve models could replicate the actual mitral valve prolapses within acceptable dimensional differences. Our concepts are useful for better 3D valve creation and better surgical planning with reliable 3D valve models.
确定二尖瓣脱垂的复杂几何形状通常很困难。我们构建了六个脱垂二尖瓣的三维模型用于手术评估，并评估这些模型复制各个瓣膜尺寸的准确性。基于一种针对计算机断层扫描图像的原始分割方法构建三维多边形数据。通过手术中实际心脏与这些模型之间的尺寸比较来确认模型的复制性能。结果显示，在所有病例中脱垂节段均匹配；然而，在四个病例中复制出了断裂的腱索。前外侧平均高度差为0.0毫米（标准差1.6，范围-2至+2毫米），脱垂瓣叶中心平均高度差为0.0毫米（标准差1.7，范围-2至+2毫米），后内侧平均高度差为-1.5毫米（标准差0.6，范围-1至-2毫米）。回归分析显示出强正相关，布兰德-奥特曼图表明模型与实际心脏在数量上具有相似性。我们得出结论，我们的三维瓣膜模型能够在可接受的尺寸差异范围内复制实际的二尖瓣脱垂。我们的理念对于利用可靠的三维瓣膜模型更好地创建三维瓣膜和进行更好的手术规划很有用。
