Probabilistic Modeling of Stenotic Aortic Valve Intervention

狭窄主动脉瓣介入的概率建模

基本信息

批准号：
8731269
负责人：
Wei Sun
金额：
$ 35.78万
依托单位：
GEORGIA INSTITUTE OF TECHNOLOGY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-08-20 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8731269
关键词：
Academia Academic Medical Centers Anatomy Aorta Aortic Injury Aortic Valve Stenosis Area Biomechanics Cadaver Cardiac Cardiac Surgery procedures Cardiac Tamponade Cardiology Cardiovascular system Clinical Clinical Trials Comorbidity Computer Analysis Computer Simulation Coronary Coronary Occlusions Coronary artery Data Databases Development Device Designs Devices Disease Elastic Tissue Elderly Elements Extravasation Future Geometry Goals Heart Heart Valve Diseases Heart Valves Height Hospitals Human Image Image Analysis Impairment Implant Individual Industry Injury Intervention Investigation Lead Liquid substance Maps Measurement Measures Medical Device Designs Methodology Methods Mitral Valve Insufficiency Modeling New York Obstruction Patients Performance Plant Roots Positioning Attribute Prevalence Procedures Process Property Prosthesis Radial Recovery Research Research Personnel Research Proposals Safety Scanning Series Severe Adverse Event Shapes Site Statistical Models Stents Structure Surgical Valves Techniques Testing Thoracic Surgical Procedures Time Tissues Trauma Variant Western World X-Ray Computed Tomography abstracting aging population aortic valve base bioimaging computer framework computerized tools demographics design experience hemodynamics high risk implantation knowledge base migration minimally invasive mortality novel patient population pressure reconstruction research study screening success valve replacement

项目摘要

DESCRIPTION (provided by applicant): Project Summary/Abstract Aortic stenosis is the most common valvular heart disease in the Western world and its prevalence is growing with an aging population. The current preferred method of treatment is complete valve replacement with a surgically implanted prosthetic valve. However, for high-risk patients with advanced age and co- morbidities, operative mortality escalates. Recently, minimally invasive transcatheter aortic valve (TAV) implantation has been investigated as an endovascular alternative to surgical valve replacement. Although significant experience has been gained, TAV implantation clinical trials have been associated with complications such as device migration, paravalvular leakage, coronary obstruction, and access site injury. Furthermore, the long-term durability and safety of TAV prostheses are largely unknown and must be evaluated and studied carefully. To gain a quantitative understanding of the biomechanics involved in TAV intervention, our objectives in this project are to develop probabilistic computational models to investigate aortic tissue-TAV structural interaction and hemodynamics under a variety of patient conditions, and to offer scientific rationale for TAV patient screening and TAV design improvement. To accomplish these goals, the following specific aims are proposed: 1) Investigation of elastic properties and microstructure of the human stenotic aortic root through a series of biomechanical tests performed on 50 human cadaver hearts; 2) Image analysis of clinical CT scans, which will yield 60 reconstructed patient-specific aortic valve geometries. Statistical shape models will be developed to facilitate the reconstruction process as well as the description of anatomic geometric variation among the patient population; and 3) Probabilistic computational analysis of aortic tissue-TAV structural interaction and hemodynamics. Deterministic finite element (FE) models and computational fluid dynamics (CFD) models will be developed using 12 actual TAV patient data measured prior to the TAV intervention, and validated by the post-TAV clinical CT scans, flow and pressure measurements. A statistical description of patient material properties and geometric variations will be mapped into the computational models and a probabilistic analysis will be conducted to evaluate aortic tissue-TAV structural interaction and hemodynamics. The fundamental study of the biomechanics involved in TAV intervention and the computational modeling of tissue-implant interaction proposed here could lead to the development of a new knowledgebase that has been previously unavailable to academia, clinicians, and the heart valve industry. The methodologies and computational framework developed in this study will serve as a basis for future studies, which will include more design and environmental variables such as different patient demographics, and could also be utilized to facilitate the development of other novel device designs or pre-operative patient screening techniques for different valve diseases, such as mitral valve regurgitation.

描述（由申请人提供）：项目摘要/抽象主动脉狭窄是西方世界中最常见的瓣膜心脏病，其患病率正在随着人口老龄而增长。当前的首选治疗方法是用手术植入的假体瓣膜完全替换瓣膜。但是，对于高危患者，患者高龄和病毒率，手术死亡率升级。最近，已研究了微创经导管主动脉瓣（TAV）植入作为手术瓣膜置换的一种血管内替代品。尽管已经获得了丰富的经验，但TAV植入临床试验与诸如器件迁移，旁腔泄漏，冠状动脉阻塞和进入部位损伤等并发症有关。此外，TAV假体的长期耐用性和安全性在很大程度上是未知的，必须仔细评估和研究。为了获得对TAV干预中涉及的生物力学的定量理解，我们在该项目中的目标是开发概率计算模型，以研究各种患者条件下主动脉组织-TAV结构性相互作用和血液动力学，并为TAV患者筛查和TAV设计改进提供科学的理由。为了实现这些目标，提出了以下特定目标：1）通过对50种人体尸体心脏进行的一系列生物力学测试研究弹性特性和人狭窄主动脉词的微观结构； 2）临床CT扫描的图像分析，该分析将产生60种重建的患者特异性主动脉瓣几何形状。将开发统计形状模型，以促进重建过程以及对患者人群中解剖几何变异的描述； 3）主动脉组织-TAV结构相互作用和血液动力学的概率计算分析。确定性有限元（FE）模型和计算流体动力学（CFD）模型将使用在TAV干预之前测量的12个实际TAV患者数据开发，并通过TAV后临床CT扫描，流量和压力测量结果进行验证。患者材料特性和几何变化的统计描述将映射到计算模型中，并将进行概率分析以评估主动脉组织-TAV结构相互作用和血液动力学。对TAV干预涉及的生物力学以及此处提出的组织植入物相互作用的计算建模的基本研究可能会导致一个新知识基础的发展，该新知识基础以前对学术界，临床医生和心脏瓣膜行业无法使用。本研究中开发的方法和计算框架将作为未来研究的基础，其中将包括更多的设计和环境变量，例如不同的患者人口统计学，并且还可以用于促进其他新型设备设计或用于不同瓣膜疾病的术前患者筛查技术（例如MITRALARARALADEASES），例如Mitreal Valve Refurgurogurogurogurogurogurogurogurogurogurgutitation。