Noterdaeme Timothée, Gesenhues Jonas, Vogt Felix, Massberg Steffen, Marx Nikolaus
Department of Cardiology & Intensive Care Medicine, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.
Institute of Automatic Control, RWTH Aachen University, Aachen, Germany.
Front Cardiovasc Med. 2021 Apr 30;8:665029. doi: 10.3389/fcvm.2021.665029. eCollection 2021.
This study assessed the basic working principle to measure aortic annulus resistance during balloon inflation for transcatheter aortic valve implantation (TAVI), by acquisition of pressure-volume curve for a guided semi-automatic implantation. A modular bench-system was used which allows the incremental inflation of valvuloplasty balloons by means of a stepper-motor driven linear axis with simultaneous recording of the pressure changes inside the system. Different porcine aortic xenografts were assessed by use of a non-compliant valvuloplasty balloon. In a second step transcatheter aortic stents were implanted inside target sized xenografts. The recorded pressure volume-curves showed that the system can accurately differentiate between different xenografts and assess the quality of the tissue rendering real-time analysis of pressure-volume curves during balloon-inflation possible, which has the potential to optimize the implantation procedure by direct adaptation to the patient specific anatomy and characteristics. Further investigations and development are warranted.
本研究通过获取用于引导半自动植入的压力-容积曲线，评估了经导管主动脉瓣植入术（TAVI）中球囊膨胀期间测量主动脉瓣环阻力的基本工作原理。使用了一个模块化实验台系统，该系统通过步进电机驱动的线性轴允许逐步膨胀瓣膜成形球囊，同时记录系统内部的压力变化。使用非顺应性瓣膜成形球囊评估了不同的猪主动脉异种移植物。第二步，将经导管主动脉支架植入目标尺寸的异种移植物内。记录的压力-容积曲线表明，该系统可以准确区分不同的异种移植物，并评估组织质量，从而在球囊膨胀期间对压力-容积曲线进行实时分析，这有可能通过直接适应患者的特定解剖结构和特征来优化植入过程。有必要进行进一步的研究和开发。
