Department of Surgery, University of Minnesota, Visible Heart®Laboratories, 420 Delaware St. SE, B172 Mayo, MMC 195, Minneapolis, MN, 55455, USA.
Biomed Eng Online. 2023 Mar 18;22(1):27. doi: 10.1186/s12938-023-01090-2.
Percutaneous coronary interventions (PCIs) within left main coronary arteries are high-risk procedures that require optimization of interactions between stent(s) and diseased vessels. Optical Coherence Tomography (OCT) is a widely accepted tool that enhances physicians' ability to assess proper stent appositions during clinical procedures. The primary aim of this study was to develop complementary post-procedure imaging methodologies to better assess and interpret outcomes of left main PCI procedures, utilizing both reanimated and perfusion-fixed human hearts.
PCIs were performed while obtaining OCT scans within the left main anatomies of six human hearts. Subsequently, each heart was scanned with a micro-CT scanner with optimized parameters to achieve resolutions up to 20 µm. Scans were reconstructed and imported into a DICOM segmentation software to generate computational models of implanted stents and associated coronary vessels. 2D images from OCT that were obtained during PCIs were compared to the 3D models generated from micro-CT reconstructions. In addition, the 3D models were utilized to create virtual reality scenes and enlarged 3D prints for development of "mixed reality" tools relative to bifurcation stenting within human left main coronary arteries.
We developed reproducible methodologies for post-implant analyses of coronary artery stenting procedures. In addition, we generated high-resolution 3D computational models, with ~ 20-micron resolutions, of PCIs performed within reanimated and perfusion-fixed heart specimens.
Generated computational models of left main PCIs performed in isolated human hearts can be used to obtain detailed measurements that provide further clinical insights on procedural outcomes. The 3D models from these procedures are useful for generating virtual reality scenes and 3D prints for physician training and education.
经皮冠状动脉介入治疗（PCI）在左主干冠状动脉中属于高风险操作，需要优化支架与病变血管之间的相互作用。光学相干断层扫描（OCT）是一种广泛接受的工具，可增强医生在临床操作过程中评估支架正确贴壁的能力。本研究的主要目的是开发补充的术后成像方法，以更好地评估和解释左主干 PCI 操作的结果，同时利用再灌注固定和灌注固定的人类心脏。
在 6 个人类心脏的左主干解剖结构内进行 PCI 操作的同时获取 OCT 扫描。随后，使用优化参数的微 CT 扫描仪对每个心脏进行扫描，以达到高达 20μm 的分辨率。对扫描进行重建并导入 DICOM 分割软件，以生成植入支架和相关冠状动脉的计算模型。在 PCI 过程中获得的 OCT 的 2D 图像与从微 CT 重建生成的 3D 模型进行比较。此外，还利用 3D 模型创建了虚拟现实场景和放大的 3D 打印，以开发相对于人类左主干冠状动脉分叉支架的“混合现实”工具。
我们开发了用于冠状动脉支架置入术术后分析的可重复方法。此外，我们生成了具有 20 微米分辨率的高分辨率 3D 计算模型，用于在再灌注固定和灌注固定的心脏标本中进行 PCI。
在离体人心内进行的左主干 PCI 产生的计算模型可用于获得详细的测量值，从而进一步深入了解手术结果。这些操作的 3D 模型可用于生成虚拟现实场景和 3D 打印，以进行医师培训和教育。
