一种用于主动脉瓣修复术中可视化加压根部的新型装置。
A Novel Device for Intraoperative Direct Visualization of a Pressurized Root in Aortic Valve Repair.
机构信息
Department of Cardiothoracic Surgery, Stanford University, Stanford, California; Department of Bioengineering, Stanford University, Stanford, California.
Department of Cardiothoracic Surgery, Stanford University, Stanford, California; Department of Mechanical Engineering, Stanford University, Stanford, California.
出版信息
Ann Thorac Surg. 2022 Aug;114(2):567-571. doi: 10.1016/j.athoracsur.2022.02.013. Epub 2022 Feb 22.
PURPOSE
One major challenge in generating reproducible aortic valve (AV) repair results is the inability to assess AV morphology under physiologic pressure. A transparent intraoperative AV visualization device was designed and manufactured.
DESCRIPTION
This device comprises an open proximal end, a cantilevered edge to allow attachment of the device to the aorta or graft, a distal viewing surface, and 2 side ports for fluid delivery and air removal.
EVALUATION
The performance of the device was evaluated ex vivo using normal porcine AV in situ (n = 3), porcine AV after valve-sparing aortic root replacement (VSARR) (n = 3), porcine pulmonary valve in the Ross procedure (n = 3), and in 3 patients who underwent VSARR. AV morphology was clearly visualized using the device in all experiments. In human subjects, the use of this device successfully showed cusp prolapse after the initial VSARR and effectively guided additional cusp repair.
CONCLUSIONS
This device successfully allows for direct visual assessment of the AV apparatus under physiologic pressure. The use of this device can potentially increase the adoptability of AV repair in clinical practice.
目的
在生成可重现的主动脉瓣 (AV) 修复结果方面，一个主要挑战是无法在生理压力下评估 AV 形态。设计并制造了一种透明的术中 AV 可视化设备。
描述
该设备包括一个开放的近端、一个允许将设备附着到主动脉或移植物的悬臂边缘、一个远端观察表面和 2 个侧端口，用于输送流体和去除空气。
评估
该设备的性能通过在体使用正常的猪 AV 进行了离体评估（n=3）、主动脉瓣保留根部替换术后的猪 AV（n=3）、Ross 手术中的猪肺动脉瓣（n=3）以及 3 例接受主动脉瓣保留根部替换术的患者进行了评估。在所有实验中，该设备均清晰地显示了 AV 形态。在人体受试者中，该设备的使用成功地显示了初始主动脉瓣保留根部替换术后的瓣叶脱垂，并有效地指导了额外的瓣叶修复。
结论
该设备成功地允许在生理压力下直接对 AV 装置进行视觉评估。该设备的使用可能会增加 AV 修复在临床实践中的可接受性。
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