دورية أكاديمية
أعرض في EDS

Finite element modeling with patient-specific geometry to assess clinical risks of percutaneous pulmonary valve implantation.

التفاصيل البيبلوغرافية
العنوان: Finite element modeling with patient-specific geometry to assess clinical risks of percutaneous pulmonary valve implantation.
المؤلفون: Donahue CL; Department of Biomedical Engineering, University of Minnesota, Twin Cities, Minnesota, USA., Westman CL; Department of Biomedical Engineering, University of Minnesota, Twin Cities, Minnesota, USA., Faanes BL; Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA., Qureshi AM; Department of Pediatrics, The Lillei Frank Abercombie Section of Pediatric Cardiology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA., Barocas VH; Department of Biomedical Engineering, University of Minnesota, Twin Cities, Minnesota, USA., Aggarwal V; Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA.
المصدر: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2024 May; Vol. 103 (6), pp. 924-933. Date of Electronic Publication: 2024 Apr 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 100884139 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-726X (Electronic) Linking ISSN: 15221946 NLM ISO Abbreviation: Catheter Cardiovasc Interv Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Wiley-Liss, c1999-
مواضيع طبية MeSH: Pulmonary Valve*/physiopathology , Pulmonary Valve*/surgery , Pulmonary Valve*/diagnostic imaging , Heart Valve Prosthesis Implantation*/instrumentation , Heart Valve Prosthesis Implantation*/adverse effects , Finite Element Analysis* , Patient-Specific Modeling* , Heart Valve Prosthesis* , Models, Cardiovascular* , Prosthesis Design* , Cardiac Catheterization*/adverse effects , Cardiac Catheterization*/instrumentation, Humans ; Risk Assessment ; Adolescent ; Treatment Outcome ; Risk Factors ; Male ; Child ; Retrospective Studies ; Female ; Young Adult ; Predictive Value of Tests ; Hemodynamics ; Stents ; Pulmonary Valve Insufficiency/physiopathology ; Pulmonary Valve Insufficiency/surgery ; Pulmonary Valve Insufficiency/diagnostic imaging ; Pulmonary Valve Insufficiency/etiology ; Ventricular Outflow Obstruction/physiopathology ; Ventricular Outflow Obstruction/etiology ; Ventricular Outflow Obstruction/diagnostic imaging ; Clinical Decision-Making ; Adult
مستخلص: Background: Percutaneous pulmonary valve implantation (PPVI) is a non-surgical treatment for right ventricular outflow tract (RVOT) dysfunction. During PPVI, a stented valve, delivered via catheter, replaces the dysfunctional pulmonary valve. Stent oversizing allows valve anchoring within the RVOT, but overexpansion can intrude on the surrounding structures. Potentially dangerous outcomes include aortic valve insufficiency (AVI) from aortic root (AR) distortion and myocardial ischemia from coronary artery (CA) compression. Currently, risks are evaluated via balloon angioplasty/sizing before stent deployment. Patient-specific finite element (FE) analysis frameworks can improve pre-procedural risk assessment, but current methods require hundreds of hours of high-performance computation.
Methods: We created a simplified method to simulate the procedure using patient-specific FE models for accurate, efficient pre-procedural PPVI (using balloon expandable valves) risk assessment. The methodology was tested by retrospectively evaluating the clinical outcome of 12 PPVI candidates.
Results: Of 12 patients (median age 14.5 years) with dysfunctional RVOT, 7 had native RVOT and 5 had RV-PA conduits. Seven patients had undergone successful RVOT stent/valve placement, three had significant AVI on balloon testing, one had left CA compression, and one had both AVI and left CA compression. A model-calculated change of more than 20% in lumen diameter of the AR or coronary arteries correctly predicted aortic valve sufficiency and/or CA compression in all the patients.
Conclusion: Agreement between FE results and clinical outcomes is excellent. Additionally, these models run in 2-6 min on a desktop computer, demonstrating potential use of FE analysis for pre-procedural risk assessment of PPVI in a clinically relevant timeframe.
(© 2024 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
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معلومات مُعتمدة: NIH grant U01-HL139471; T32-HL139431; Andrew David Sit Foundation Innovators Fund award
فهرسة مساهمة: Keywords: balloon testing; pulmonary valve; transcatheter; valve replacement
تواريخ الأحداث: Date Created: 20240410 Date Completed: 20240426 Latest Revision: 20240426
رمز التحديث: 20240426
DOI: 10.1002/ccd.31016
PMID: 38597297
قاعدة البيانات: MEDLINE
الوصف
تدمد:1522-726X
DOI:10.1002/ccd.31016