首页|基于有限元方法的K-Clip手术过程再现及分析

基于有限元方法的K-Clip手术过程再现及分析

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目的 利用数值模拟研究使用K-Clip治疗三尖瓣反流时,针对不同反流形态,植入位置和器械型号对治疗效果的影响.方法 利用CT影像进行三维重建,得到心脏主体模型.修改标准的参数化三尖瓣叶及腱索得到两种不同的反流瓣口.在商业显式动力学软件Ls-Dyna中模拟不同型号的K-Clip夹合部件在植入不同位置(后瓣中点、前后瓣交界、前瓣中点、后隔瓣交界)的效果.结论 针对本文中的两种反流形态,夹合后瓣中点会造成更好的反流瓣口缩小效果(最多缩小75%的反流瓣口面积).在前瓣中点以及后隔瓣交界植入时,所需夹紧力更大,不利于夹合部件的顺利关闭.比较18T与16T的夹合部件的植入后情况,发现并没有明显的治疗区别,且16T夹合部件所需夹紧力更小,因此推荐优先使用16T夹合部件.
Reconstruction and analysis of K-Clip surgery process based on finite element method
Objective To investigate the effects of different types of tricuspid regurgitation,implantation positions,and device models on the treatment outcomes of K-Clip for tricuspid regurgitation using numerical simulations.Methods Three-dimensional reconstruction of the heart model was performed based on CT images.Two different regurgitation orifices were obtained by modifying the standard parameterized tricuspid valve leaflets and chordae tendineae.The effects of different K-Clip models at different implantation positions(posterior leaflet midpoint,anterior-posterior commissure,anterior leaflet midpoint,posterior septal commissure)were simulated using commercial explicit dynamics software Ls-Dyna.Conclusion For the two types of regurgitation in this study,clipping at the posterior leaflet midpoint resulted in a better reduction of the regurgitation orifice(up to 75%reduction in area).Higher clamping forces were required for implantation at the anterior leaflet midpoint and posterior septal commissure,which was unfavorable for the smooth closure of the clipping components.There was no statistical difference in the treatment outcomes between the 18T and 16T K-Clip components,and the 16T component required less clamping force.Therefore,the use of the 16T K-Clip component is recommended.

Tricuspid regurgitationannulus repairK-Clipnumerical simulation

施浩、欧阳文斌、李世国、李琦、张凤文、刘垚、鲁雯馨、刘畅、张少杰、潘湘斌

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中国医学科学院北京协和医学院国家心血管病中心阜外医院结构性心脏病中心国家卫生健康委心血管疾病再生医学研究重点实验室国家心血管疾病重点实验室中国医学科学院心血管创新器械重点实验室国家心血管疾病临床医学研究中心国家重点实验室(北京 100037)

上海汇禾医疗科技股份有限公司(上海 201612)

三尖瓣反流 瓣环修复 K-Clip 数值模拟

中央级公益性科研院所基本科研业务费国家自然科学基金中央高水平医院临床科研业务费

2019PT350005819704442022-GSP-QN-15

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(1)
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