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首页> 外文期刊>Journal of Biomechanics >Modeling leaflet correction techniques in aortic valve repair: A finite element study.
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Modeling leaflet correction techniques in aortic valve repair: A finite element study.

机译：主动脉瓣修复中的小叶校正技术建模：有限元研究。

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摘要

In aortic valve sparing surgery, cusp prolapse is a common cause of residual aortic insufficiency. To correct cusp pathology, native leaflets of the valve frequently require adjustment which can be performed using a variety of described correction techniques, such as central or commissural plication, or resuspension of the leaflet free margin. The practical question then arises of determining which surgical technique provides the best valve performance with the most physiologic coaptation. To answer this question, we created a new finite element model with the ability to simulate physiologic function in normal valves, and aortic insufficiency due to leaflet prolapse in asymmetric, diseased or sub-optimally repaired valves. The existing leaflet correction techniques were simulated in a controlled situation, and the performance of the repaired valve was quantified in terms of maximum leaflets stress, valve orifice area, valve opening and closing characteristics as well as total coaptation area in diastole. On the one hand, the existing leaflet correction techniques were shown not to adversely affect the dynamic properties of the repaired valves. On the other hand, leaflet resuspension appeared as the best technique compared to central or commissural leaflet plication. It was the only method able to achieve symmetric competence and fix an individual leaflet prolapse while simultaneously restoring normal values for mechanical stress, valve orifice area and coaptation area.
机译：在保留主动脉瓣的手术中，尖瓣脱垂是残余主动脉瓣关闭不全的常见原因。为了矫正尖尖病理，瓣膜的天然小叶经常需要进行调节，这可以使用多种所述的矫正技术来执行，例如中央或连合的plication折，或重悬小叶的自由边缘。于是，就产生了一个实际问题，即确定哪种外科手术技术可提供最佳的瓣膜性能和最佳的生理适应性。为了回答这个问题，我们创建了一个新的有限元模型，该模型能够模拟正常瓣膜的生理功能以及由于不对称，患病或修复欠佳的瓣膜的小叶脱垂而导致的主动脉瓣关闭不全。现有的小叶校正技术是在受控的情况下模拟的，修复后的瓣膜的性能通过最大瓣叶应力，瓣膜孔面积，瓣膜的打开和关闭特性以及舒张期的总接合面积来量化。一方面，现有的小叶校正技术显示出不会对修复后的瓣膜的动态特性产生不利影响。另一方面，与中央或连合的小叶折叠相比，小叶重悬似乎是最好的技术。这是唯一能够实现对称能力并固定单个小叶脱垂，同时恢复机械应力，瓣膜孔面积和接合面积正常值的方法。

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