跨导管大动脉更换中的跨导管大动脉更换的参数分析:冠状动脉流阻塞的评估
Roberta Scuoppo1, Stefano Cannata2, Giovanni Gentile3
1Department of Engineering, Università Degli Studi di Palermo, Palermo, Italy.
Frontiers in bioengineering and biotechnology
|October 27, 2023
概括
透气管大动脉置换在透气管大动脉置换 (TAVR-in-TAVR) 中可以减少冠状动脉血流. 使用有限元分析进行适当的规划对于在年轻患者中保持足够的血液流动至关重要.
科学领域:
- 心血管医学 心血管医学
- 生物医学工程 生物医学工程
- 计算流体动力学的流体动力学.
背景情况:
- 通过导管的大动脉置换 (TAVR) 越来越多地用于年轻患者,预期寿命更长.
- TAVR-in-TAVR是一种治疗过导管心脏 (THV) 失败的策略,但它可能会损害冠状动脉接入.
- 降低冠状动脉血流是TAVR中的TAVR的潜在并发症.
研究的目的:
- 用有限元分析 (FEA) 来量化TAVR-in-TAVR患者的冠状动脉血流减少.
- 为了研究植入深度和装置大小在TAVR-in-TAVR期间对冠状动脉流量的影响.
- 评估到冠状动脉距离和冠状动脉流量之间的关系.
主要方法:
- 用有限元分析 (FEA) 来模拟TAVR中的TAVR程序.
- FEA模型包括 SAPIEN 3 Ultra THV 的顺序部署,然后是 Evolut PRO 设备.
- 参数调查探讨了植入深度和设备大小的变化.
主要成果:
- 高植入深度和第二THV的不足大小显著降低了冠状动脉流量 (高达80%).
- 在冠状动脉流量和到冠状动脉距离之间发现了正相关性 (R=0.86对于LCA,R=0.93对于RCA).
- 根据部署参数,FEA表明了显著的冠状动脉流量减少的潜力.
结论:
- 计算建模,特别是FEA,可以为TAVR中的TAVR提供关键的见解.
- 使用FEA进行程序前规划可以帮助优化THV放置以保持冠状动脉流动.
- 这种方法可能会改善接受TAVR-in-TAVR的年轻患者的结果.
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