Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Mais filtros








Base de dados
Intervalo de ano de publicação
1.
Catheter Cardiovasc Interv ; 103(6): 924-933, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38597297

RESUMO

BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is a non-surgical treatment for right ventricular outflow tract (RVOT) dysfunction. During PPVI, a stented valve, delivered via catheter, replaces the dysfunctional pulmonary valve. Stent oversizing allows valve anchoring within the RVOT, but overexpansion can intrude on the surrounding structures. Potentially dangerous outcomes include aortic valve insufficiency (AVI) from aortic root (AR) distortion and myocardial ischemia from coronary artery (CA) compression. Currently, risks are evaluated via balloon angioplasty/sizing before stent deployment. Patient-specific finite element (FE) analysis frameworks can improve pre-procedural risk assessment, but current methods require hundreds of hours of high-performance computation. METHODS: We created a simplified method to simulate the procedure using patient-specific FE models for accurate, efficient pre-procedural PPVI (using balloon expandable valves) risk assessment. The methodology was tested by retrospectively evaluating the clinical outcome of 12 PPVI candidates. RESULTS: Of 12 patients (median age 14.5 years) with dysfunctional RVOT, 7 had native RVOT and 5 had RV-PA conduits. Seven patients had undergone successful RVOT stent/valve placement, three had significant AVI on balloon testing, one had left CA compression, and one had both AVI and left CA compression. A model-calculated change of more than 20% in lumen diameter of the AR or coronary arteries correctly predicted aortic valve sufficiency and/or CA compression in all the patients. CONCLUSION: Agreement between FE results and clinical outcomes is excellent. Additionally, these models run in 2-6 min on a desktop computer, demonstrating potential use of FE analysis for pre-procedural risk assessment of PPVI in a clinically relevant timeframe.


Assuntos
Cateterismo Cardíaco , Análise de Elementos Finitos , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Modelos Cardiovasculares , Modelagem Computacional Específica para o Paciente , Desenho de Prótese , Valva Pulmonar , Humanos , Valva Pulmonar/fisiopatologia , Valva Pulmonar/cirurgia , Valva Pulmonar/diagnóstico por imagem , Implante de Prótese de Valva Cardíaca/instrumentação , Implante de Prótese de Valva Cardíaca/efeitos adversos , Medição de Risco , Adolescente , Resultado do Tratamento , Fatores de Risco , Masculino , Criança , Estudos Retrospectivos , Feminino , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/instrumentação , Adulto Jovem , Valor Preditivo dos Testes , Hemodinâmica , Stents , Insuficiência da Valva Pulmonar/fisiopatologia , Insuficiência da Valva Pulmonar/cirurgia , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Insuficiência da Valva Pulmonar/etiologia , Obstrução do Fluxo Ventricular Externo/fisiopatologia , Obstrução do Fluxo Ventricular Externo/etiologia , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Tomada de Decisão Clínica , Adulto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA