Biomechanical Optimization of Cardiac Valve Repair Operations

心脏瓣膜修复手术的生物力学优化

基本信息

批准号：
10158270
负责人：
Y Joseph Woo
金额：
$ 68.97万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-05-05 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10158270
关键词：
3D Print Address Adoption Advocate Anatomy Aneurysm Animal Model Animals Anterior Anticoagulation Aortic Valve Insufficiency Appearance Biomechanics Bioprosthesis device Cardiac Cardiac Surgery procedures Clinical Complex Custom Data Deterioration Devices Dilatation - action Dimensions Disease Early Intervention Engineering Evolution Excision Future Geometry Guidelines Head Health Heart Heart Valve Diseases Heart Valves Height Hemorrhage Human Imaging technology Individual Investigation Knowledge Left Lesion Location Magnetic Resonance Imaging Measures Mechanics Mitral Valve Mitral Valve Insufficiency Mitral Valve Prolapse Modeling Modification Morbidity - disease rate Motion Operating Rooms Operative Surgical Procedures Outcome Patient Care Patients Performance Perioperative Physiological Plant Roots Ptosis Publishing Risk Specimen Stress Surgical Replantation Surgical sutures System Techniques Translating Tubular formation United States Validation Ventricular Visual aortic valve base biomechanical engineering clinical application clinically relevant design experimental study hemodynamics hexapod implantation improved in vivo innovation mortality novel operation papillary muscle reconstruction repaired sensor technology treatment guidelines valve replacement

项目摘要

PROJECT SUMMARY Valvular heart disease is a significant cause of global morbidity and mortality. Evolving treatment guidelines support earlier intervention and valve repair when possible. Advances in repair techniques have progressed in the clinical arena primarily based upon anatomic and physiologic premises and occasionally based upon visual and echocardiographic appearance. Yet, the biomechanical engineering fundamentals and principles underlying valvuloplasty operations are rarely investigated. A more robust understanding of such principles and incorporation into surgical procedures may enhance valve reparability and durability and thus ultimately translate into less thromboembolic and hemorrhagic sequelae of long term anticoagulation for mechanical valve replacement and less perioperative risks of reintervention for bioprosthetic valve deterioration. We have designed and produced a novel 3D-printed left heart simulator into which mitral and aortic valve specimens can be mounted and studied throughout the cardiac cycle. Multiple regurgitant disease states can be reproduced, as can the current clinically-employed repair operations. Innovative biomechanical sensors and imaging technologies facilitate the detailed analysis of the engineering principles within these operations. Comparisons of and identification of notable functional differences among contemporary operative techniques have already been discovered and published from investigations performed using this heart valve system. We propose to study in depth aortic and mitral valve repair operations ex vivo and then validate findings in large animal models. We are optimistic that the proposed experiments will yield important knowledge on current and potential future clinical therapies for valve disease and can be rapidly translated to intraoperative patient care.

项目概要瓣膜性心脏病是全球发病率和死亡率的重要原因。不断发展的治疗指南尽可能支持早期干预和瓣膜修复。修复技术取得了长足的进步临床领域主要基于解剖学和生理学前提，偶尔也基于视觉和超声心动图表现。然而，生物力学工程的基础和原则瓣膜成形术很少被研究。对这些原则有更深入的理解纳入外科手术可能会增强瓣膜的可修复性和耐用性，从而最终转化为瓣膜减少机械瓣膜长期抗凝的血栓栓塞和出血后遗症更换和减少因生物瓣膜恶化而再次干预的围手术期风险。我们有设计并生产了一种新型 3D 打印左心模拟器，二尖瓣和主动脉瓣标本可以放入其中在整个心动周期中进行安装和研究。可以再现多种反流疾病状态，如可以进行目前临床上采用的修复手术。创新的生物力学传感器和成像技术有助于对这些操作中的工程原理进行详细分析。比较当代手术技术之间显着功能差异的研究和识别已经是通过使用该心脏瓣膜系统进行的研究发现并发表的。我们建议深入研究主动脉瓣和二尖瓣离体修复手术，然后在大型动物模型中验证研究结果。我们乐观地认为，拟议的实验将产生有关当前和潜在未来的重要知识瓣膜疾病的临床治疗，可以快速转化为术中患者护理。