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首页> 外文期刊>Philosophical transactions of the Royal Society. Mathematical, physical, and engineering sciences >Patient-specific reconstructed anatomies and computer simulations are fundamental for selecting medical device treatment: Application to a new percutaneous pulmonary valve
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Patient-specific reconstructed anatomies and computer simulations are fundamental for selecting medical device treatment: Application to a new percutaneous pulmonary valve

机译：特定于患者的重建解剖结构和计算机模拟对于选择医疗器械治疗至关重要：应用于新型经皮肺动脉瓣

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Nowadays, percutaneous pulmonary valve implantation is a successful alternative to surgery for patients requiring treatment of pulmonary valve dysfunction. However, owing to the wide variety of implantation site morphology, size and dynamics, only about 15 per cent of cases are suitable for current devices. In order to increase the number of patients who could benefit from minimally invasive procedures, a new valved stent graft for percutaneous implantation has been designed recently. In this study, patient-specific computational analyses have been applied to investigate the suitability of new device designs, using real data from 62 patients who had undergone surgical pulmonary valve replacement. Magnetic resonance images of these patients before surgery were elaborated using imaging post-processing software to reconstruct the three-dimensional volume of each patient's implantation site. Three stent designs were created and tested in these patient outflow tracts using finite-element simulations: stent graft SG1 resembles the first device tested in animals; stent graft SG2 is a custom device tailored for a specific patient morphology; and stent graft SG3 represents a hypothetical larger device. The three devices showed an implantation success rate of 37 per cent, 42 per cent and 63 per cent, respectively. Using patient-specific simulations, we have shown that a percutaneous approach with these new devices may be possible for many patients who are currently referred for surgery. Furthermore, when the new devices become available, the methodologies described may help clinicians in the decision-making process, by enabling virtual implantation prior to the actual procedure.
机译：如今，对于需要治疗肺动脉瓣功能障碍的患者，经皮肺动脉瓣植入术已成为手术的成功替代方案。但是，由于植入部位的形态，大小和动力学各异，仅约15％的病例适合当前设备。为了增加可以从微创手术中受益的患者数量，最近已经设计了一种用于经皮植入的新的带瓣膜支架移植物。在这项研究中，已使用来自患者的计算分析方法来研究新设备设计的适用性，它使用了来自62位接受了手术肺动脉瓣置换的患者的真实数据。使用成像后处理软件精心制作这些患者在手术前的磁共振图像，以重建每个患者植入部位的三维体积。使用有限元模拟创建了三种支架设计，并在这些患者流出道中对其进行了测试：支架SG1类似于在动物中测试的第一种设备; SG2支架移植物是针对特定患者形态量身定制的定制设备;支架移植物SG3代表一个假想的较大装置。这三种装置的植入成功率分别为37％，42％和63％。使用针对患者的模拟，我们已经表明，对于目前被转介手术的许多患者，使用这些新设备进行经皮入路可能是可行的。此外，当新设备可用时，所描述的方法可以通过在实际操作之前进行虚拟植入来帮助临床医生进行决策。

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