【摘要】：目的通過(guò)有限元方法評(píng)估不同鈣化模式對(duì)經(jīng)導(dǎo)管主動(dòng)脈瓣膜植入效果的影響。方法根據(jù)鈣化斑塊在主動(dòng)脈瓣葉上的位置不同,建立對(duì)合線鈣化模型、附著線鈣化模型和圓圈鈣化模型3種不同鈣化形式的主動(dòng)脈根部模型。使用ABAQUS軟件仿真自膨脹經(jīng)導(dǎo)管主動(dòng)脈瓣膜植入3個(gè)鈣化模型中的過(guò)程,分析不同鈣化模型對(duì)主動(dòng)脈根部應(yīng)力、瓣架變形以及瓣周間隙的影響。結(jié)果圓圈鈣化模型中鈣化斑塊的最大主應(yīng)力最大,為18.42 MPa,可能導(dǎo)致假體植入后發(fā)生腦卒中的風(fēng)險(xiǎn)更高;圓圈鈣化模型的瓣架變形程度也最大,可能導(dǎo)致更差的假體耐久性;附著線鈣化模型的瓣周間隙面積為37.2 mm~2,超過(guò)其他模型的2倍,植入后出現(xiàn)嚴(yán)重瓣周返流的風(fēng)險(xiǎn)可能性更高。結(jié)論不同的主動(dòng)脈瓣葉鈣化模式與經(jīng)導(dǎo)管主動(dòng)脈瓣膜植入后的主動(dòng)脈根部應(yīng)力、瓣架變形以及瓣周間隙有關(guān),對(duì)術(shù)后并發(fā)癥和假體耐久性產(chǎn)生影響。研究結(jié)果為臨床上經(jīng)導(dǎo)管主動(dòng)脈瓣膜植入術(shù)術(shù)后效果的預(yù)測(cè)提供參考。
[Abstract]:Objective to evaluate the effect of different calcification patterns on transcatheter aortic valve implantation by finite element method. Methods according to the different position of calcified plaques in the aortic valve lobe, three different calcification models of aortic root were established, including involutive line calcification model, attachment line calcification model and circle calcification model. ABAQUS software was used to simulate the process of self-expanding aortic valve implanted into three calcification models. The effects of different calcification models on aortic root stress, flap deformation and perivalvular space were analyzed. Results in the circle calcification model, the maximum principal stress of calcified plaques was the largest, and 18.42 MPa, might lead to a higher risk of stroke after implantation. Circle calcification model also has the largest deformation degree, which may lead to worse durability of prosthesis. The perivalvular space area of the attachment line calcification model was 37.2 mm~2, larger than that of the other models, and the risk of severe perivalvular regurgitation after implantation was higher. Conclusion different aortic valve calcification patterns are related to aortic root stress, flap deformation and peri-valvular space after transcatheter aortic valve implantation, which have an effect on postoperative complications and prosthesis durability. The results provide a reference for clinical prediction of postoperative outcome of transcatheter aortic valve implantation.
【作者單位】： 北京航空航天大學(xué)生物與醫(yī)學(xué)工程學(xué)院生物力學(xué)與力生物學(xué)教育部重點(diǎn)實(shí)驗(yàn)室;金仕生物科技(常熟)有限公司;國(guó)家康復(fù)輔具研究中心;
【基金】：國(guó)家自然科學(xué)基金項(xiàng)目(11421202,11572029) 國(guó)家重點(diǎn)研發(fā)計(jì)劃子課題(2016YFC1102202)
【分類號(hào)】：R654.2

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