Chiara Catalano , Stefano Cannata , Valentina Agnese , Giovanni Gentile , Caterina Gandolfo , Salvatore Pasta
{"title":"经导管二尖瓣置换术的频谱:ViR、ViV和ViMAC中新LVOT面积的计算机和体外评估","authors":"Chiara Catalano , Stefano Cannata , Valentina Agnese , Giovanni Gentile , Caterina Gandolfo , Salvatore Pasta","doi":"10.1016/j.bprint.2023.e00285","DOIUrl":null,"url":null,"abstract":"<div><p>The assessment of the neo-left ventricular outflow tract (neo-LVOT) area is an essential metric for pre-procedural imaging when screening patients for transcatheter mitral valve replacement (TMVR) eligibility. Indeed, the implantation of transcatheter heart valves for treating failed annuloplasty band ring (ViR), bioprosthesis (ViV) and mitral valve calcification (ViMAC) can lead to a permanent obstruction of the implanted device (namely, LVOT obstruction). In this study, in silico computational modeling and 3D printing were used to quantify the neo-LVOT area and the resulting hemodynamic outcomes of TMVR. We first simulated the deployment of the SAPIEN 3 Ultra device (Edwards Lifesciences, Irvine, CA) and then evaluated the pressure drop near the LVOT obstruction using computational fluid dynamics. The neo-LVOT area was largest in patients with ViR (453.4 ± 58.1 mm<sup>2</sup>) compared to patients with ViV (246.6 ± 109.5 mm<sup>2</sup>) and ViMAC (155.6 ± 46.1 mm<sup>2</sup>). The pressure drop near the LVOT obstruction differed among patients with TMVRs and significantly correlated with the magnitude of the neo-LVOT area (R = −0.761 and P-value = 0.047). The present study highlights the potential of in silico and 3D printed models for planning TMVR procedures and for carrying out a risk evaluation of the device protrusion into the left heart when treating failed mitral valves.</p></div>","PeriodicalId":37770,"journal":{"name":"Bioprinting","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"On the spectrum of transcatheter mitral valve replacement: In silico and in vitro assessment of neo-LVOT area in ViR, ViV and ViMAC\",\"authors\":\"Chiara Catalano , Stefano Cannata , Valentina Agnese , Giovanni Gentile , Caterina Gandolfo , Salvatore Pasta\",\"doi\":\"10.1016/j.bprint.2023.e00285\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>The assessment of the neo-left ventricular outflow tract (neo-LVOT) area is an essential metric for pre-procedural imaging when screening patients for transcatheter mitral valve replacement (TMVR) eligibility. Indeed, the implantation of transcatheter heart valves for treating failed annuloplasty band ring (ViR), bioprosthesis (ViV) and mitral valve calcification (ViMAC) can lead to a permanent obstruction of the implanted device (namely, LVOT obstruction). In this study, in silico computational modeling and 3D printing were used to quantify the neo-LVOT area and the resulting hemodynamic outcomes of TMVR. We first simulated the deployment of the SAPIEN 3 Ultra device (Edwards Lifesciences, Irvine, CA) and then evaluated the pressure drop near the LVOT obstruction using computational fluid dynamics. The neo-LVOT area was largest in patients with ViR (453.4 ± 58.1 mm<sup>2</sup>) compared to patients with ViV (246.6 ± 109.5 mm<sup>2</sup>) and ViMAC (155.6 ± 46.1 mm<sup>2</sup>). The pressure drop near the LVOT obstruction differed among patients with TMVRs and significantly correlated with the magnitude of the neo-LVOT area (R = −0.761 and P-value = 0.047). The present study highlights the potential of in silico and 3D printed models for planning TMVR procedures and for carrying out a risk evaluation of the device protrusion into the left heart when treating failed mitral valves.</p></div>\",\"PeriodicalId\":37770,\"journal\":{\"name\":\"Bioprinting\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bioprinting\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405886623000283\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Computer Science\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bioprinting","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405886623000283","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Computer Science","Score":null,"Total":0}
On the spectrum of transcatheter mitral valve replacement: In silico and in vitro assessment of neo-LVOT area in ViR, ViV and ViMAC
The assessment of the neo-left ventricular outflow tract (neo-LVOT) area is an essential metric for pre-procedural imaging when screening patients for transcatheter mitral valve replacement (TMVR) eligibility. Indeed, the implantation of transcatheter heart valves for treating failed annuloplasty band ring (ViR), bioprosthesis (ViV) and mitral valve calcification (ViMAC) can lead to a permanent obstruction of the implanted device (namely, LVOT obstruction). In this study, in silico computational modeling and 3D printing were used to quantify the neo-LVOT area and the resulting hemodynamic outcomes of TMVR. We first simulated the deployment of the SAPIEN 3 Ultra device (Edwards Lifesciences, Irvine, CA) and then evaluated the pressure drop near the LVOT obstruction using computational fluid dynamics. The neo-LVOT area was largest in patients with ViR (453.4 ± 58.1 mm2) compared to patients with ViV (246.6 ± 109.5 mm2) and ViMAC (155.6 ± 46.1 mm2). The pressure drop near the LVOT obstruction differed among patients with TMVRs and significantly correlated with the magnitude of the neo-LVOT area (R = −0.761 and P-value = 0.047). The present study highlights the potential of in silico and 3D printed models for planning TMVR procedures and for carrying out a risk evaluation of the device protrusion into the left heart when treating failed mitral valves.
期刊介绍:
Bioprinting is a broad-spectrum, multidisciplinary journal that covers all aspects of 3D fabrication technology involving biological tissues, organs and cells for medical and biotechnology applications. Topics covered include nanomaterials, biomaterials, scaffolds, 3D printing technology, imaging and CAD/CAM software and hardware, post-printing bioreactor maturation, cell and biological factor patterning, biofabrication, tissue engineering and other applications of 3D bioprinting technology. Bioprinting publishes research reports describing novel results with high clinical significance in all areas of 3D bioprinting research. Bioprinting issues contain a wide variety of review and analysis articles covering topics relevant to 3D bioprinting ranging from basic biological, material and technical advances to pre-clinical and clinical applications of 3D bioprinting.