动态:一种具有选择性刚度节段的患者特异性二尖瓣成形术环。

Pub Date : 2022-09-01 DOI:10.1115/1.4054445
Samuel Frishman, Ali Kight, Ileana Pirozzi, Sainiteesh Maddineni, Annabel M Imbrie-Moore, Zulekha Karachiwalla, Michael J Paulsen, Alexander D Kaiser, Y Joseph Woo, Mark R Cutkosky
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引用次数: 0

摘要

环成形术环的选择和设计对二尖瓣修复的远期疗效至关重要。DynaRing是一种选择性柔顺的环形成形术环,由不同刚度的弹性体段、形状固定的镍钛诺芯和交叉直径的长丝组成。该环提供足够的刚度来稳定病变环空,同时允许生理环空动力学。此外,调整弹性体性能提供了一种机制,可以有效地调整关键的MV指标,以适应特定的患者。我们用离体左心脏模拟器评估了嵌入猪瓣膜的环,并通过定制的振荡系统进行了1.5亿次循环疲劳测试。我们提出了一种特定于患者的设计方法,用于使用有限元模型优化和患者MRI数据来确定环参数。离体实验结果表明,dyaring的运动与文献中关于健康环空的数值非常接近。针对患者的优化结果表明,DynaRing能够分别调整前后径、节间径和鞍座高度,调整幅度分别高达8.8%、5.6%和19.8%,并与广泛的患者数据相匹配。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
DynaRing: A Patient-Specific Mitral Annuloplasty Ring With Selective Stiffness Segments.

Annuloplasty ring choice and design are critical to the long-term efficacy of mitral valve (MV) repair. DynaRing is a selectively compliant annuloplasty ring composed of varying stiffness elastomer segments, a shape-set nitinol core, and a cross diameter filament. The ring provides sufficient stiffness to stabilize a diseased annulus while allowing physiological annular dynamics. Moreover, adjusting elastomer properties provides a mechanism for effectively tuning key MV metrics to specific patients. We evaluate the ring embedded in porcine valves with an ex-vivo left heart simulator and perform a 150 million cycle fatigue test via a custom oscillatory system. We present a patient-specific design approach for determining ring parameters using a finite element model optimization and patient MRI data. Ex-vivo experiment results demonstrate that motion of DynaRing closely matches literature values for healthy annuli. Findings from the patient-specific optimization establish DynaRing's ability to adjust the anterior-posterior and intercommissural diameters and saddle height by up to 8.8%, 5.6%, 19.8%, respectively, and match a wide range of patient data.

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