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
{"title":"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。","authors":"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","doi":"10.1115/1.4054445","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":73816,"journal":{"name":"","volume":"16 3","pages":"031009"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125864/pdf/med-21-1009_031009.pdf","citationCount":"0","resultStr":"{\"title\":\"DynaRing: A Patient-Specific Mitral Annuloplasty Ring With Selective Stiffness Segments.\",\"authors\":\"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\",\"doi\":\"10.1115/1.4054445\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":73816,\"journal\":{\"name\":\"\",\"volume\":\"16 3\",\"pages\":\"031009\"},\"PeriodicalIF\":0.0,\"publicationDate\":\"2022-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125864/pdf/med-21-1009_031009.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1115/1.4054445\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1115/1.4054445","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.