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Evaluation of mitral chordae tendineae length using four-dimensional computed

World Journal of Cardiology 2024年第5期16卷 274-281页

作者： Takuya Mori Satoshi Matsushita Terumasa Morita Abulaiti Abudurezake Junji Mochizuki Atsushi Amano Department of Cardiovascular Surgery Juntendo University Faculty of MedicineTokyo 113-8421Japan Department of Cardiovascular Surgery JACCT Japan Animal Cardiovascular Care TeamOsaka 533-0033Japan Department of Radiology Minamino Cardiovascular HospitalTokyo 192-0918Japan

BACKGROUND Mitral valvuloplasty using artificial chordae tendineae represents an effective surgical approach for treating mitral *** precise measurements of artificial chordae tendineae length(CL)is an important factor in the procedure;however,no objective index currently exists to facilitate this ***,preoperative assessment of CL is critical for surgical planning and ***-dimensional x-ray micro-computed tomography(4D-CT)may be useful for accurate CL measurement considering that it allows for dynamic three-dimensional(3D)evaluation compared to that with transthoracic echocardiography,a conventional inspection *** To investigate the behavior and length of mitral chordae tendineae during systole using *** Eleven adults aged>70 years without mitral valve disease were evaluated.A 64-slice CT scanner was used to capture 20 phases in the cardiac cycle in electrocardiographic *** length of the primary chordae tendineae was measured from early systole to early diastole using the 3D *** primary chordae tendineae originating from the anterior papillary muscle and attached to the A1-2 region and those from the posterior papillary muscle and attached to the A2-3 region were designated as cA and cP,*** behavior and maximum lengths[cA(ma),cP(max)]were compared,and the correlation with body surface area(BSA)was *** In all cases,the mitral anterior leaflet chordae tendineae could be *** most cases,the cA and cP chordae tendineae could be measured *** mean cA(max)and cP(max)were 20.2 mm±1.95 mm and 23.5 mm±4.06 mm,***(max)was significantly *** correlation coefficients(r)with BSA were 0.60 and 0.78 for cA(max)and cP(max),*** cA and cP exhibited constant variation in CL during systole,with a maximum 1.16-fold increase in cA and a 1.23-fold increase in cP from early to *** cP,CL reached a plateau at 15%and remaine

关键词： Mitral valve Chordae tendineae Computed tomography Four-dimensional cardiac cycle

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A novel angiography-based computational modelling for assessing the dynamic stress and quantitative fatigue fracture risk of the coronary stents immediately after implantation: Effects of stent materials, designs and target vessel motions

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Medicine in Novel Technology and Devices 2022年第2期14卷 31-38页

作者： Xinlei Wu Mattia Lunardi Ahmed Elkoumy Jiayue Huang Jing Kan Shaoliang Chen Shengxian Tu Shanghai Med-X Engineering Research Center Shanghai Jiao Tong UniversityShanghaiChina Institute of Cardiovascular Development and Translational Medicine The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina Department of Cardiology National University of IrelandGalway(NUIG)GalwayIreland Division of Cardiology Nanjing First HospitalNanjing Medical UniversityNanjingChina Med-X Research Institute Shanghai Jiao Tong UniversityShanghaiChina

Fluctuating stress on the implanted coronary stents within cardiac cycle is an important mechanism of fatigue fracture,which is associated with in-stent restenosis and stent *** developed a novel computational modelling to calculate the dynamic stress of stents based on the time sequence angiography immediately after *** groups of patient-specific cases(one same stent design treated in 4 different coronary arteries and one same artery actually/virtually implanted one stent with 3 different designs)were performed the dynamic stress analysis by this computational modelling and subsequently assessed the fatigue fracture risk by Goodman *** motion of target arteries significantly impacts on distribution of the stress and the risk of stent fracture,particularly in the site of hinge *** the location of stent stress concentration in the obtuse marginal artery and the“unsafe”region in the inverse fatigue safety factor contour co-registered with the position of complete transverse fracture 13 months later after *** stents with different designs had the same location of highest stress concentration at the hinge motion site of the actually/virtually treated *** strength stent materials are significantly lower the risk of stent fracture rather than stent *** new computational modelling might be a useful tool in assessment of fracture risk of the implanted stent and in optimizing new design of dedicated stent treated specific coronary arteries and mechanical properties in vivo of bioresorbable scaffold during degradation process.

关键词： Coronary angiography Dynamic stress Superficial wall strain Fatigue analysis cardiac cycle Cardiovascular biomechanics

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