不同钙化模式对经导管主动脉瓣膜植入效果影响的数值模拟研究

发布时间：2019-01-21 19:15

【摘要】：目的通过有限元方法评估不同钙化模式对经导管主动脉瓣膜植入效果的影响。方法根据钙化斑块在主动脉瓣叶上的位置不同,建立对合线钙化模型、附着线钙化模型和圆圈钙化模型3种不同钙化形式的主动脉根部模型。使用ABAQUS软件仿真自膨胀经导管主动脉瓣膜植入3个钙化模型中的过程,分析不同钙化模型对主动脉根部应力、瓣架变形以及瓣周间隙的影响。结果圆圈钙化模型中钙化斑块的最大主应力最大,为18.42 MPa,可能导致假体植入后发生脑卒中的风险更高;圆圈钙化模型的瓣架变形程度也最大,可能导致更差的假体耐久性;附着线钙化模型的瓣周间隙面积为37.2 mm~2,超过其他模型的2倍,植入后出现严重瓣周返流的风险可能性更高。结论不同的主动脉瓣叶钙化模式与经导管主动脉瓣膜植入后的主动脉根部应力、瓣架变形以及瓣周间隙有关,对术后并发症和假体耐久性产生影响。研究结果为临床上经导管主动脉瓣膜植入术术后效果的预测提供参考。
[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.
【作者单位】：北京航空航天大学生物与医学工程学院生物力学与力生物学教育部重点实验室;金仕生物科技(常熟)有限公司;国家康复辅具研究中心;
【基金】：国家自然科学基金项目(11421202,11572029) 国家重点研发计划子课题(2016YFC1102202)
【分类号】：R654.2

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