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在猪模型中通过力传感器和超声心动图测量评估天然主动脉瓣环的不对称动力学。

Asymmetric Dynamics of the Native Aortic Annulus Evaluated by Force Transducer and Sonomicrometry in a Porcine Model.

作者信息

Benhassen Leila Louise, Ropcke Diana Mathilde, Lading Troels, Skov Jens Kæstel, Bechsgaard Tommy, Skov Søren Nielsen, Nielsen Sten Lyager, Hasenkam John Michael

机构信息

Department of Clinical Medicine, Aarhus University Hospital, Skejby, Aarhus, Denmark.

Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Cardiovasc Eng Technol. 2019 Sep;10(3):482-489. doi: 10.1007/s13239-019-00418-1. Epub 2019 Jun 7.

DOI:10.1007/s13239-019-00418-1
PMID:31175615
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6715665/
Abstract

PURPOSE

With new repair techniques of the aortic root and valve emerging, a detailed understanding of the dynamics of the aortic annulus and valve is required for optimal results. The objective of this study was to characterize geometrical changes and force distribution of the native porcine aortic annulus throughout the cardiac cycle.

METHODS

Measurements were performed in an acute 80 kg porcine model (n = 7) using sonomicrometry crystals in the aortic annulus for evaluation of geometry and dynamics, annular force transducer evaluating force distribution, and pressure measurements and echocardiography evaluating valve performance.

RESULTS

Overall, segmental force distribution and geometrical changes differed between different segments of the aortic annulus. The highest force development was found at the left/right interleaflet triangle (2.87 ± 2.1 N) and the largest segmental expansion was observed at the right-coronary and left-coronary sinus. The aortic annulus changed configuration throughout the cardiac cycle and became more oval in systole.

CONCLUSIONS

This study is the first to describe detailed segmental dynamics and force distribution of the native aortic annulus in a porcine model in vivo. The heterogenous behavior of the aortic annulus suggests that different segments demand different support for repair of the aortic root and valve.

摘要

目的

随着主动脉根部和瓣膜新修复技术的出现，为获得最佳效果，需要对主动脉瓣环和瓣膜的动力学有详细了解。本研究的目的是描述天然猪主动脉瓣环在整个心动周期中的几何变化和力分布。

方法

在一个急性80千克猪模型（n = 7）中进行测量，使用置于主动脉瓣环的超声测微晶体评估几何形状和动力学，使用环形力传感器评估力分布，并通过压力测量和超声心动图评估瓣膜性能。

结果

总体而言，主动脉瓣环不同节段的节段力分布和几何变化有所不同。在左/右瓣叶间三角区发现最高的力发展（2.87±2.1牛），在右冠状动脉窦和左冠状动脉窦观察到最大的节段扩张。主动脉瓣环在整个心动周期中改变形态，在收缩期变得更呈椭圆形。

结论

本研究首次描述了天然主动脉瓣环在猪体内模型中的详细节段动力学和力分布。主动脉瓣环的异质性行为表明，主动脉根部和瓣膜修复时不同节段需要不同的支撑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/64aa58fc351d/13239_2019_418_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/6c359e792b20/13239_2019_418_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/e8701729162a/13239_2019_418_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/5eaa5f4f90ed/13239_2019_418_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/132bdf4db5f9/13239_2019_418_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/9e021d122173/13239_2019_418_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/64aa58fc351d/13239_2019_418_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/6c359e792b20/13239_2019_418_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/e8701729162a/13239_2019_418_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/5eaa5f4f90ed/13239_2019_418_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/132bdf4db5f9/13239_2019_418_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/9e021d122173/13239_2019_418_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030d/6715665/64aa58fc351d/13239_2019_418_Fig6_HTML.jpg

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