小叶类型和支架附着高度对经导管主动脉瓣小叶血栓形成电位的影响

IF 0.8 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Beatrice Ncho, Andrew W. Siefert, V. Sadri, Jillian Ortner, A. Yoganathan
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引用次数: 2

摘要

经导管主动脉瓣置换术的小叶材料和小叶附着在支架瓣膜架上的高度各不相同。这些特征的组合可影响小叶动力学、新窦几何形状和流体动力学,从而减少或加剧血流停滞和小叶血栓形成的可能性。为了研究这些相互关联的关系,本研究评估了经导管瓣膜小叶类型(猪与牛心包)和小叶支架附着高度(低、中、高)对血流停滞和小叶血栓形成的影响。经导管瓣膜模型制造和测试在主动脉模拟器脉动左心血流动力学条件下。通过直接测量、高速成像和两种不同的颗粒图像测速技术来评估经瓣血流动力学、小叶运动学和血流结构。经导管瓣膜与猪心包小叶被观察到较不僵硬,表现出较小的血流阻力,与新窦血流停滞区域减少和上窦冲洗时间有关。更多的小叶附着物升高与较少的新窦血流停滞有关。这些初步的结果和观察表明,小叶类型和支架附着高度的结合可以减少经导管主动脉瓣血流停滞和小叶血栓形成的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Leaflet Type and Leaflet-Stent Attachment Height on Transcatheter Aortic Valve Leaflet Thrombosis Potential
Transcatheter aortic valve replacement devices vary in leaflet material and in the height for which leaflets attach to the stented valve frame. Combinations of these features can influence leaflet dynamics, neo-sinus geometries, and fluid dynamics, thereby reducing or exacerbating the potential for blood flow stasis and leaflet thrombosis. To investigate these interconnected relationships, this study evaluated the effects of transcatheter valve leaflet type (porcine vs. bovine pericardium) and the leaflet-stent attachment height (low, mid, and high) on flow stasis and potential for leaflet thrombosis. Transcatheter valve models were manufactured and tested within an aortic simulator under pulsatile left heart hemodynamic conditions. Transvalvular hemodynamics, leaflet kinematics, and flow structures were evaluated by direct measurement, high-speed imaging, and two differing techniques of particle image velocimetry. Transcatheter valves with porcine pericardial leaflets were observed to be less stiff, exhibit a lesser resistance to flow, were associated with reduced regions of neo-sinus flow stasis, and superior sinus washout times. More elevated attachments of the leaflets were associated with less neo-sinus flow stasis. These initial results and observations suggest combinations of leaflet type and stent attachment height may reduce transcatheter aortic valve flow stasis and the potential for leaflet thrombosis.
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来源期刊
CiteScore
1.80
自引率
11.10%
发文量
56
审稿时长
6-12 weeks
期刊介绍: The Journal of Medical Devices presents papers on medical devices that improve diagnostic, interventional and therapeutic treatments focusing on applied research and the development of new medical devices or instrumentation. It provides special coverage of novel devices that allow new surgical strategies, new methods of drug delivery, or possible reductions in the complexity, cost, or adverse results of health care. The Design Innovation category features papers focusing on novel devices, including papers with limited clinical or engineering results. The Medical Device News section provides coverage of advances, trends, and events.
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