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结构柔顺性对人工心脏瓣膜空化阈值测量的影响。

Effect of structural compliance on cavitation threshold measurement of mechanical heart valves.

作者信息

Guo G X, Adlparvar P, Howanec M, Roy J, Kafesjian R, Kingsbury C

机构信息

Edwards CVS Division of Baxter, Irvine, California 92714-5686.

出版信息

J Heart Valve Dis. 1994 Apr;3 Suppl 1:S77-83; discussion S83-4.

PMID:8061872
Abstract

An in vitro study was designed to evaluate the effect of structural compliance on cavitation threshold measurements of mechanical heart valves. Using a dual channel high speed video image analysis method, the experiment was carried out in a pulse duplicator under a single, simulated physiologic condition. Each valve was mounted on a compliance adjustable fixture. One video camera served as a displacement monitor, while the other monitored cavitation bubbles at the inflow side of the valve. On-line adjustment of the mounting compliance allowed for cavitation threshold detection with respect to compliance without influencing the testing condition. Visible cavitation bubbles disappeared when the compliance was increased. Ten 29 mm mitral valves, including two each of St. Jude Medical, Carbomedics, Edwards-Duromedics (ED), Edwards Tekna (ET) and Medtronic-Hall (MH) were tested. All the bileaflet valves tested in this study showed similar cavitation thresholds at a compliance range of 0.5-0.65 mil/lb at a dp/dt of 4,000 mmHg/sec (averaged dp/dt during valve closure). Under the same dp/dt, MH monoleaflet valves showed a higher compliance range of 3.5-3.8 mil/lb to achieve the cavitation threshold. This study demonstrated that the mounting compliance of the valve must be known and well controlled in order to quantify the cavitation threshold with respect to dp/dt. In addition, the more compliant sewing ring of the ET valve may be responsible for higher cavitation thresholds with respect to dp/dt as observed in previous studies. The present in vitro study suggests that the investigation of the sewing structural compliance may be essential for the evaluation of in vivo cavitation potential.

摘要

一项体外研究旨在评估结构顺应性对机械心脏瓣膜空化阈值测量的影响。采用双通道高速视频图像分析方法,在单一模拟生理条件下的脉动复制器中进行实验。每个瓣膜安装在一个顺应性可调节的夹具上。一台摄像机用作位移监测器,另一台监测瓣膜流入侧的空化气泡。通过在线调整安装顺应性,可以在不影响测试条件的情况下检测与顺应性相关的空化阈值。当顺应性增加时,可见的空化气泡消失。测试了10个29毫米的二尖瓣,其中包括圣犹达医疗、卡波美迪克斯、爱德华兹-杜罗美迪克斯(ED)、爱德华兹泰克纳(ET)和美敦力-霍尔(MH)各两个。在4000 mmHg/秒的dp/dt(瓣膜关闭期间的平均dp/dt)下,本研究中测试的所有双叶瓣膜在0.5-0.65密耳/磅的顺应性范围内显示出相似的空化阈值。在相同的dp/dt下,MH单叶瓣膜显示出更高的顺应性范围,为3.5-3.8密耳/磅才能达到空化阈值。这项研究表明,为了量化与dp/dt相关的空化阈值,必须了解并很好地控制瓣膜的安装顺应性。此外,如先前研究中所观察到的,ET瓣膜更具顺应性的缝合环可能是导致与dp/dt相关的空化阈值较高的原因。目前的体外研究表明,对缝合结构顺应性的研究可能对评估体内空化潜力至关重要。

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