计算机断层扫描衍生程序模拟用于重新透过导管的大动脉替换
Mark M P van den Dorpel1, Ole de Backer2, Mohamed Abdel-Wahab3
1Cardiovascular Institute, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
概括
使用FEops HEARTguide软件进行的重复透气管大动脉替换 (redo-TAVR) 模拟准确预测冠状动脉可访问性和扩张. 这项试点研究验证了软件的有效性.
科学领域:
- 心血管成像和干预方法
- 医学中的计算建模.
- 假肢的性能分析
背景情况:
- 过导管大动脉 (TAV) 失效需要重复TAVR,造成诸如冠状动脉接入受损和由于多层门而导致假肢患者不匹配等风险.
- 多切片计算机断层扫描 (MSCT) 成像与专用软件相结合,有可能模拟TAV部署以预测结果.
- 准确的模拟对于规划重复TAVR程序和减轻潜在并发症至关重要.
研究的目的:
- 为了验证 FEops HEARTguide 软件生成的 redo-TAVR 模拟的准确性.
- 评估软件能够预测重点手术和解剖结果在重复TAVR患者的能力.
主要方法:
- 一项多中心观察性研究包括25名患者,他们接受了可用的基线,后指数TAVR和后重复TAVRMSCT成像的重复TAVR.
- 使用FEops HEARTguide软件创建了针对患者的重复TAVR模拟.
- 模拟结果包括到冠状动脉 (VTC) 距离,新皮高度,TAV扩张和残留面积与随访MSCT数据进行了比较.
主要成果:
- 模拟显示,对VTC距离 (ICC > 0.740) 和TAV框架扩展 (ICC > 0.822) 的后续MSCT与良好一致.
- 对于门到鼻管结 (VTSTJ) 距离 (ICC > 0.613) 观察到适度的协议.
- 剩余门面积的模拟显示了自扩展和气球可扩展的TAV的良好一致性 (ICC > 0.823).
结论:
- 使用FEops HEARTguide的MSCT衍生模拟提供了对冠状动脉可访问性,TAV扩张和 redo-TAVR中的残留面积的准确见解.
- 这些发现支持模拟软件在规划和优化重复TAVR程序中的潜在实用性.
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