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首页> 外文期刊>European Heart Journal - Case Reports >Pre-procedural planning of transcatheter mitral valve replacement in mitral stenosis with multi-detector tomography-derived 3D modeling and printing: a case report
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Pre-procedural planning of transcatheter mitral valve replacement in mitral stenosis with multi-detector tomography-derived 3D modeling and printing: a case report

机译：多透视型断层摄影三维建模和印刷二尖瓣狭窄转基因分子瓣膜置换的预程序规划：案例报告

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Background Transcatheter mitral valve replacement (TMVR) may be a valuable treatment option for mitral annular calcification and severe mitral stenosis (MS) in patients at high operative risk. Pre-procedural virtual and printed simulations may aid in procedure planning, device sizing, and mitigate complications such as valve embolization or left ventricular outflow tract (LVOT) obstruction. Case summary We describe a case of TMVR in which multi-detector computed tomography (MDCT) derived, three-dimensional virtual planning and a 3D-printed model of the patients’ left heart provided enhanced understanding of an individual patient’s unique anatomy to determine feasibility, device sizing, and risk stratification. This resulted in deployment of an adequately sized valve. Post-TMVR LVOT obstruction was treated with LVOT balloon dilatation and percutaneous transluminal septal myocardial ablation. Discussion Advanced MDCT-derived planning techniques introduce consistent 3D modeling and printing to enhance understanding of intracardiac anatomical relationships and test device implantation. Still, static measurements do not feature haemodynamic factors, tissue, or device characteristics and do not predict device host interaction. Transcatheter mitral valve replacement is feasible in MS when adequately pre-procedurally planned. Multi-detector computed tomography-derived, 3D, virtual and printed models contribute to adequate planning in terms of determining patient eligibility, procedure feasibility, and device sizing. However, static 3D modeling cannot completely eliminate the risk of peri-procedural complications.
机译：背景技术经截视表二尖瓣置换术（TMVR）可能是患者在高手术风险的二尖瓣环状钙化和严重二尖瓣狭窄（MS）的有价值的治疗选择。程序预先虚拟和印刷模拟可以有助于程序规划，设备尺寸和减轻阀门栓塞或左心室流出道（LVOT）梗阻等抑制并发症。案例摘要我们描述了TMVR的情况，其中多探测器计算机断层扫描（MDCT）导出，三维虚拟规划和患者左心的3D印刷模型提供了对个体患者独特的解剖学来确定可行性的提高了解，设备尺寸和风险分层。这导致展开了适当尺寸的阀门。 TMVR后液体梗阻受到LVOT球囊扩张和经皮透镜间隔心肌消融的影响。讨论先进的MDCT衍生的规划技术引入了一致的3D建模和印刷，以增强对心内解剖关系和测试装置植入的理解。静止测量仍然不具有血管动力学因素，组织或设备特性，并且不会预测设备主机相互作用。经截面二尖瓣置换在适当程序预先计划的时候是MS的可行性。多探测器计算机断层扫描，3D，虚拟和印刷模型在确定患者资格，程序可行性和设备尺寸方面有助于适当的规划。然而，静态3D建模不能完全消除Peri-Properation并发症的风险。

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