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Apex 双叶机械心脏瓣膜。

The Apex bileaflet mechanical heart valve.

机构信息

Faculty of Applied Science, The Heart Valve Performance Laboratory, School of Engineering, University of British Columbia, Kelowna, Canada.

出版信息

J Med Eng Technol. 2021 Jan;45(1):41-51. doi: 10.1080/03091902.2020.1853835. Epub 2021 Jan 15.

Abstract

Mechanical Heart Valves (MHVs) are known for their excellent lifespan and feasibly are the most reliable and stable valves amongst all prosthetic valves. Successful bileaflet MHVs such as the St. Jude Medical (SJM) are known for providing central blood flow and minimal pressure drop across the valve. However, due to their non-physiological flow conditions, they still suffer from hemodynamic complications, that is, red blood cell (RBC) lysis and/or thrombogenicity, to date. Our hypothesis is that the design of MHVs can be improved so that their hemodynamics can be comparable to those of tissue valves. In this study, a new concept for the design of MHVs is proposed. To accomplish this, we identified the major design limitations of bileaflet MHVs, such as the gold standard SJM valve as well as the believed contributing factors to their thrombogenicity. We developed a novel design architecture for bileaflet MHVs that addressed these limitations, and from it, the Apex Valve (AV). Our experimental assessment of the AV found that its hemodynamics were closer to that of a bioprosthetic valve than of a bileaflet MHV. This design has been filed as a US Provisional Patent.

摘要

机械心脏瓣膜(MHV)以其出色的使用寿命而闻名,并且在所有人工瓣膜中,它可能是最可靠和最稳定的瓣膜。像圣犹达医疗(SJM)这样成功的双叶 MHV 以提供中央血流和穿过瓣膜的最小压力降而闻名。然而,由于其非生理流动条件,它们仍然存在血液动力学并发症,即红细胞(RBC)溶解和/或血栓形成,至今仍未得到解决。我们的假设是,MHV 的设计可以得到改进,以便其血液动力学性能可以与组织瓣膜相媲美。在这项研究中,提出了一种设计 MHV 的新概念。为了实现这一目标,我们确定了双叶 MHV 的主要设计限制,例如金标准 SJM 瓣膜以及被认为导致其血栓形成的因素。我们为双叶 MHV 开发了一种新颖的设计架构,解决了这些限制,由此产生了 Apex Valve(AV)。我们对 AV 的实验评估发现,其血液动力学性能更接近生物瓣,而不是双叶 MHV。该设计已作为美国临时专利申请提交。

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