深度学习和三维打印引导下的经导管主动脉瓣置换术和冠状动脉保护术

IF 1.2 4区 医学 Q3 SURGERY
Yu Mao, Guangyu Zhu, Mengen Zhai, Yanyan Ma, Lanlan Li, Ping Jin, Yang Liu, Jian Yang
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引用次数: 0

摘要

本病例报告探讨了深度学习和三维打印技术在围手术期的辅助作用,以同时指导经导管主动脉瓣置换术和冠状动脉支架植入术。门诊部的超声心动图结果显示主动脉严重狭窄,并伴有反流和胸腔积液。患者首先接受了胸腔闭式引流术。在收集了 800 毫升胸腔积液后,患者的症状得到缓解,并被送入医院。术前经胸超声心动图显示主动脉瓣严重双尖瓣狭窄,合并钙化和主动脉瓣反流(平均压力梯度为 42 毫米汞柱)。术前计算机断层扫描结果显示主动脉瓣为I型双尖瓣,伴有严重的偏心钙化。从左冠状动脉平面可以看到瓣叶,这表明冠状动脉阻塞的可能性极高。术前成像评估后,利用深度学习和三维打印技术进行了评估和模拟。在引导下成功完成了经导管主动脉瓣置换术和冠状动脉支架植入术。术后数字减影血管造影显示,生物假体和烟囱冠状动脉支架均处于理想位置。结论 深度学习和三维打印的围手术期指导对重度双尖瓣主动脉瓣狭窄伴钙化和高危冠状动脉阻塞患者的手术策略制定有很大帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transcatheter Aortic Valve Replacement and Coronary Protection Guided by Deep Learning and 3-Dimensional Printing
ObjectiveIn this case report, the auxiliary role of deep learning and 3-dimensional printing technology in the perioperative period was discussed to guide transcatheter aortic valve replacement and coronary stent implantation simultaneously.Case presentationA 68-year-old man had shortness of breath and chest tightness, accompanied by paroxysmal nocturnal dyspnea, 2 weeks before presenting at our hospital. Echocardiography results obtained in the outpatient department showed severe aortic stenosis combined with regurgitation and pleural effusion. The patient was first treated with closed thoracic drainage. After 800 mL of pleural effusion was collected, the patient’s symptoms were relieved and he was admitted to the hospital. Preoperative transthoracic echocardiography showed severe bicuspid aortic valve stenosis combined with calcification and aortic regurgitation (mean pressure gradient, 42 mmHg). Preoperative computed tomography results showed a type I bicuspid aortic valve with severe eccentric calcification. The leaflet could be seen from the left coronary artery plane, which indicated an extremely high possibility of coronary obstruction. After preoperative imaging assessment, deep learning and 3-dimensional printing technology were used for evaluation and simulation. Guided transcatheter aortic valve replacement and a coronary stent implant were completed successfully. Postoperative digital subtraction angiography showed that the bioprosthesis and the chimney coronary stent were in ideal positions. Transesophageal echocardiography showed normal morphology without paravalvular regurgitation.ConclusionThe perioperative guidance of deep learning and 3-dimensional printing are of great help for surgical strategy formulation in patients with severe bicuspid aortic valve stenosis with calcification and high-risk coronary obstruction.
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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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