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In vitro bench testing using patient-specific 3D models for percutaneous pulmonary valve implantation with Venus P-valve

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Chinese Medical Journal 2024年第8期137卷 990-996页

作者： Yu Han Zehua Shao Zirui Sun Yan Han Hongdang Xu Shubo Song Xiangbin Pan Peter P.T.de Jaegere Taibing Fan Gejun Zhang Department of Structure heart Disease Central China Fuwai Hospital of Zhengzhou UniversityZhengzhouHenan 451460China Children’s heart Center Central China Fuwai Hospital of Zhengzhou UniversityZhengzhouHenan 451460China Department of Anesthesiology Central China Fuwai Hospital of Zhengzhou UniversityZhengzhouHenan 451460China Department of Structure heart Disease Fuwai Hospital Chinese Academy of Medical SciencesBeijing 100037China Department of Cardiology Erasmus MCRotterdam 3015 GDNetherlands

Background:Due to the wide variety of morphology,size,and dynamics,selecting an optimal valve size and location poses great difficulty in percutaneous pulmonary valve implantation(PPVI).This study aimed to report our experience with in vitro bench testing using patient-specific three-dimensional(3D)-printed models for planning PPVI with the Venus ***:Patient-specific 3D soft models were generated using PolyJet printing with a compliant synthetic material in 15 patients scheduled to undergo PPVI between July 2018 and July 2020 in Central China Fuwai Hospital of Zhengzhou ***:3D model bench testing altered treatment strategy in all patients(100%).One patient was referred for surgery because testing revealed that even the largest Venus P-valve would not anchor *** the remaining 14 patients,valve size and/or implantation location was altered to avoid valve migration and/or compression coronary *** four patients,it was decided to change the point anchoring because of inverted cone-shaped right ventricular outflow tract(RVOT)(n=2)or risk of compression coronary artery(n=2).Concerning sizing,we found that an oversize of 2-5 mm *** of the valve was dictated by the flaring of the in-and outflow portion in the pulmonary *** was successful in all 14 patients(absence of valve migration,no coronary compression,and none-to-mild residual pulmonary regurgitation[PR]).The diameter of the Venus P-valve in the 3D simulation group was significantly smaller than that of the conventional planning group(36[2]vs.32[4],Z=-3.77,Pvalve to the degree recommended by the balloon-sizing technique,as 2-5 mm sufficed.

关键词： heart valve prosthesis implantation Percutaneous pulmonary valve intervention Pulmonary regurgitation bench testing 3D printing Venus P-valve

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Mechanism and Correlated Factors of SAM Phenomenon after Aortic valve Replacement

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2007年第1期27卷 72-74页

作者：徐敬文建国舒礼良刘超张竞超赵文增 Department of Cardiovascular Surgery the First Affiliated Hospital Zhengzhou University

To investigate the mechanism and correlated factors of systolic anterior motion （SAM） phenomenon after aortic valve replacement, 48 patients with severe aortic valvular stenosis were studied. Tested by echo-Doppler one week after aortic valve replacement, the patients were divided into two groups： SAM group and non-SAM group. The data of the left ventricular end-diastolic diameters, the left ventricular end-systolic diameters, the left ventricular outflow diameters, the thickness of the interventricular septum, the posterior wall of left ventricle, the blood velocities of left ventricular outflow and intra-cavitary gradients were recorded and compared. The results showed that no patients died during or after the operation. The blood velocities of left ventricular outflow was increased significantly in 9 patients （〉2.5 m/s）, and 6 of them developed SAM phenomenon. There was significant difference in all indexes （P〈0.05 or P〈0.01） except the posterior wall of left ventricle （P〉0.05） between two groups. These indicated that the present of SAM phenomenon after aortic valve replacement may be directly related to the increase of blood velocities of left ventricular outflow and intra-cavitary gradients. It is also suggested that smaller left ventricular diastolic diameters, left ventricular systolic diameters, left ventricular outflow diameters and hypertrophy of interventricular septum may be the anatomy basis of SAM phenomenon.

关键词： aortic valvular stenosis heart valve prosthesis implantation postoperative complications

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Surgical left atrial appendage occlusion in patients with atrial fibrillation undergoing mechanical heart valve replacement

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Chinese Medical Journal 2020年第16期133卷 1891-1899页

作者： Ye Zheng Chen-Fei Rao Si-Peng Chen Li He Jian-Feng Hou Zhe Zheng Department of Cardiovascular Surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Information Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China.

Background:Surgical left atrial appendage occlusion(SLAAO)may be associated with a lower risk of thromboembolism in patientswith atrial fibrillation undergoing cardiac ***,evidence regarding the effectiveness of SLAAO in patients undergoingmechanical heart valve replacement(MHVR)is ***,we aimed to evaluate the association between SLAAO and thecardiovascular outcomes in patients with atrial fibrillation undergoing ***:We retrospectively analyzed data for 497 patients with atrial fibrillation;27.6%of the patients underwent SLAAO,andthe remainder of the patients did not(No-SLAAO group).The primary outcome was a composite of ischemic stroke,systemicembolism,and all-cause *** event-free survival rates were estimated using Kaplan-Meier curves,and weperformed multivariate Cox analyses to evaluate the association between SLAAO and *** used one-to-one propensityscore matching to balance patients’baseline characteristics,and analyzed 120 matching ***:Five patients died within 30 days postoperatively,and there were no significant differences between the two groupsregarding in-hospital complications(all P>0.05).After a median follow-up of 14 months,14 primary events ***-Meier curves showed no difference in the cumulative incidence of freedom from the primary outcome(log-rank P=0.830),hemorrhagic events(log-rank P=0.870),and the secondary outcome(log-rank P=0.730),between the two *** proportional hazards regression analysis showed no association between SLAAO and any outcome(all P>0.05).Afterpropensity score matching,cardiopulmonary bypass time and aortic cross-clamp time,and the postoperative length of stay weresignificantly longer in the SLAAO group(all P<0.05);results were similar to the unadjusted ***:Concomitant SLAAO and MHVR was associated with longer length of stay,and cardiopulmonary bypass time andaortic cross-clamp time,but was not associated with add

关键词： Atrial fibrillation heart valve prosthesis implantation Propensity score

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The effects of severe aortic stenosis and high pulmonary artery pressure on aortic valve replacement

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World Journal of Cardiovascular Diseases 2013年第7期3卷 428-432页

作者： Faruk Toktas Arif Gucu Gunduz Yumun Cuneyt Eris Serhat Yalcinkaya Mehmet Demir Tugrul Goncu Senol Yavuz Cardiovascular Surgery Department Bursa Yuksek Ihtisas Training and Research HospitalBursaTurkey Thoracic Surgery Department Bursa Yuksek Ihtisas Training and Research HospitalBursaTurkey Cardiology Department Bursa Yuksek Ihtisas Training and Research HospitalBursaTurkey

Background: Pulmonary hypertension development in pure severe aortic stenosis is a situation that affects mortality and morbidity. Material and Methods: Data from files of 31 patients with systolic pulmonary artery pressure over 50 mm Hg and with pure severe aortic stenosis, and underwent aortic valve replacement in our clinic were examined retrospectively. Results: Preoperative effort capacities of the patients were evaluated as follows according to NYHA;4 patients class 1-2, 16 patients class 3, and 11 patients class 4. Twenty-five metal, and 6 biologic aortic valves were used. Postoperative hospital mortality was recorded as 12% with 4 patients. Patients were reevaluated on the postoperative 2nd and 12th months. Pulmonary arterial pressure of the patients was measured using echocardiography. Preoperative average pulmonary artery systolic pressure was measured as 55 ± 3 mmHg. The average pressure was measured as 41 ± 3 mmHg on the 2nd, and as 37.8 ± 4 mmHg on the 12th month. The effort capacity evaluation in the postoperative 2nd month was as follows: 11 patients class 1-2, 12 patients class 3, and 4 patients class 4. The effort capacity evaluation conducted in the 12th month was: 14 patients were class 1-2, 10 patients were class 3, and 2 patients were class 4. During the follow-up 1 year, survival rate of the patients was determined as 83.8% average, 5 year survival rate was determined as 61.5%. Conclusion: We believe that AVR may be performed in severe aortic stenosis cases with high pulmonary pressure with acceptable ortality, leading to a better quality and longer life.

关键词： Aortic valve Stenosis Pulmonary Hypertension heart valve prosthesis implantation Prognosis

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