从基板测试和计算机断层分析对生物假体骨折的新见解和观点
Go Hashimoto1, Santiago Garcia2, Hirotomo Sato3
1Cardiovascular Imaging Research Center and Core Lab, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA.
Structural heart : the journal of the Heart Team
|May 27, 2024
概括
生物假肢骨折 (BVF) 通过破碎手术心脏门来优化跨导管大动脉替换 (TAVR). 最佳的骨折取决于门的材料,金属支架架构比聚合物支架架构产生更大的面积增长.
科学领域:
- 心血管外科心血管外科
- 生物医学工程 生物医学工程
- 干预心脏病学 干预心脏病学
背景情况:
- 生物假体骨折 (BVF) 是中TAVR过程中的辅助手术.
- 它旨在改善透导管心脏膜扩张并减少患者与假肢不匹配.
- BVF涉及故意使用高压气球破碎外科心脏 (SHV).
研究的目的:
- 为了研究BVF的最佳气球尺寸和压力.
- 评估BVF对SHV形态和扩张的影响.
- 根据其骨折特征对SHV进行分类.
主要方法:
- 对15个已扩展的生物假体SHV进行了基板测试.
- 通过计算机断层扫描进行形态变化和扩张的评估.
- 通过光镜观察或压力下降来定义成功的BVF.
主要成果:
- 九个门成功实现了BVF; 三个显示了支架框架中断.
- 带有金属支架 (MSF) 的门在高压 (16-20 ATM) 下破裂,而不是聚合物支架 (PSF) (6-14 ATM).
- 在MSF中,BVF增加了12.3%的流入面积,在PSF中增加了3.6%.
结论:
- 最佳的BVF策略 (气球大小,压力) 取决于SHV.
- SHV的物理性质会影响骨折的结果.
- 在PSF门中的弹性反弹限制了后BVF区域扩张.
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