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Optimal Elastomeric Scaffold Leaflet Shape for Pulmonary Heart Valve Leaflet Replacement

机译：最佳弹性脚手架齿形用于肺心瓣传单更换

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摘要

Surgical replacement of the pulmonary valve (PV) is a common treatment option for congenital pulmonary valve defects. Engineered tissue approaches to develop novel PV replacements are intrinsically complex, and will require methodical approaches for their development. Single leaflet replacement utilizing an ovine model is an attractive approach in that candidate materials can be evaluated under valve level stresses in blood contact without the confounding effects of a particular valve design. In the present study an approach for optimal leaflet shape design based on finite element (FE) simulation of a mechanically anisotropic, elastomeric scaffold for PV replacement is presented. The scaffold was modeled as an orthotropic hyperelastic material using a generalized Fung-type constitutive model. The optimal shape of the fully loaded PV replacement leaflet was systematically determined by minimizing the difference between the deformed shape obtained from FE simulation and an ex-vivo microCT scan of a native ovine PV leaflet. Effects of material anisotropy, dimensional changes of PV root, and fiber orientation on the resulting leaflet deformation were investigated. In-situ validation demonstrated that the approach could guide the design of the leaflet shape for PV replacement surgery.
机译：肺动脉瓣（PV）的外科手术置换是先天性肺动脉瓣缺损的常见治疗选择。开发新的PV替代品的工程组织方法本质上很复杂，因此需要有条不紊的方法进行开发。利用绵羊模型进行单瓣置换是一种有吸引力的方法，因为可以在血液接触的瓣膜应力下评估候选材料，而不会造成特定瓣膜设计的混淆。在本研究中，提出了一种基于有限元（FE）模拟的机械各向异性弹性体支架来替代PV的最佳小叶形状设计方法。使用广义的Fung型本构模型将脚手架建模为正交各向异性超弹性材料。通过最小化从FE模拟获得的变形形状与天然绵羊PV小叶的离体microCT扫描之间的差异，系统地确定满载PV替代小叶的最佳形状。研究了材料各向异性，PV根的尺寸变化和纤维取向对所得小叶变形的影响。原位验证表明，该方法可指导PV替代手术的小叶形状设计。

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