左心房附属物阻塞装置位置对与装置相关的血栓的潜在决定因素的影响:一个患者特异的形研究
Zhaoyang Zhong1, Yiting Gao1, Soma Kovács1
1Chair of Medical Materials and Implants, TUM School of Engineering and Design and Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany.
概括
设备类型和位置在左心房附属物阻塞 (LAAO) 后显著影响设备相关的血栓风险. 软管装置和最佳定位可以减少血栓标记物,这表明安全性得到改善.
科学领域:
- 心血管研究的心血管研究.
- 生物医学工程 生物医学工程
- 医疗器械创新 医疗器械创新
背景情况:
- 设备相关的血栓 (DRT) 是左心房附属物阻塞 (LAAO) 的并发症.
- 临床观察表明,设备类型和位置会影响DRT风险,但机械学的理解是有限的.
- 需要进行in silico研究,以探索LAAO的DRT的机械基础.
研究的目的:
- 研究LAAO设备类型 (镇静剂与非镇静剂) 和植入物位置对DRT风险标记物的影响.
- 评估残留血液,壁切应力 (WSS) 和内皮细胞激活潜力 (ECAP) 如何受到设备参数的影响.
- 为 DRT 观察到的临床风险因素提供机制性的解释.
主要方法:
- 患者特定的左心房的计算流体动力学 (CFD) 建模.
- 虚拟植入不同位置的非安抚器 (守望者) 和安抚器 (护身符) LAAO设备.
- 量化残留血液体积,WSS和ECAP以评估血栓风险.
主要成果:
- 深度植入增加了残留血液和ECAP,同时减少了WSS,表明DRT风险更高.
- 非镇静器设备的偏离轴方向进一步增加了残留血液和ECAP.
- 与非安抚器设备相比,安抚器设备表现出较低的残留血液,较高的WSS和较低的ECAP.
结论:
- 无论是LAAO设备类型还是植入物位置,都会显著影响DRT的替代标记.
- 这些发现为有关DRT风险因素的临床观察提供了机制基础.
- 在模型可以帮助优化LAAO设备设计和程序技术.
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