scholarly journals Modeling Mitral Valve Leaflets from Three-Dimensional Ultrasound

Author(s):  
Robert J. Schneider ◽  
William C. Burke ◽  
Gerald R. Marx ◽  
Pedro J. del Nido ◽  
Robert D. Howe
2010 ◽  
Vol 151 (21) ◽  
pp. 854-863 ◽  
Author(s):  
Attila Nemes ◽  
Marcel L. Geleijnse ◽  
Osama I. I. Soliman ◽  
Wim B. Vletter ◽  
Jackie S. McGhie ◽  
...  

Jelenleg az echokardiográfia a legszéleskörűbben alkalmazott rutin noninvazív diagnosztikus eljárás, amelynek segítségével a mitralis billentyű morfológiája és funkciója jellemezhető. Ennek az összefoglaló jellegű közleménynek a célja az egyik legújabb echokardiográfiás fejlesztés, a transthoracalis real-time háromdimenziós echokardiográfia szerepének bemutatása a mitralis billentyű vizsgálatában.


Author(s):  
Liuyang Feng ◽  
Hao Gao ◽  
Nan Qi ◽  
Mark Danton ◽  
Nicholas A. Hill ◽  
...  

AbstractThis paper aims to investigate detailed mechanical interactions between the pulmonary haemodynamics and left heart function in pathophysiological situations (e.g. atrial fibrillation and acute mitral regurgitation). This is achieved by developing a complex computational framework for a coupled pulmonary circulation, left atrium and mitral valve model. The left atrium and mitral valve are modelled with physiologically realistic three-dimensional geometries, fibre-reinforced hyperelastic materials and fluid–structure interaction, and the pulmonary vessels are modelled as one-dimensional network ended with structured trees, with specified vessel geometries and wall material properties. This new coupled model reveals some interesting results which could be of diagnostic values. For example, the wave propagation through the pulmonary vasculature can lead to different arrival times for the second systolic flow wave (S2 wave) among the pulmonary veins, forming vortex rings inside the left atrium. In the case of acute mitral regurgitation, the left atrium experiences an increased energy dissipation and pressure elevation. The pulmonary veins can experience increased wave intensities, reversal flow during systole and increased early-diastolic flow wave (D wave), which in turn causes an additional flow wave across the mitral valve (L wave), as well as a reversal flow at the left atrial appendage orifice. In the case of atrial fibrillation, we show that the loss of active contraction is associated with a slower flow inside the left atrial appendage and disappearances of the late-diastole atrial reversal wave (AR wave) and the first systolic wave (S1 wave) in pulmonary veins. The haemodynamic changes along the pulmonary vessel trees on different scales from microscopic vessels to the main pulmonary artery can all be captured in this model. The work promises a potential in quantifying disease progression and medical treatments of various pulmonary diseases such as the pulmonary hypertension due to a left heart dysfunction.


2021 ◽  
pp. 021849232110304
Author(s):  
Mehrnoush Toufan ◽  
Zahra Jabbary ◽  
Naser Khezerlou aghdam

Background To quantify valvular morphological assessment, some two-dimensional (2D) and three-dimensional (3D) scoring systems have been developed to target the patients for balloon mitral valvuloplasty; however, each scoring system has some potential limitations. To achieve the best scoring system with the most features and the least restrictions, it is necessary to check the degree of overlap of these systems. Also the factors related to the accuracy of these systems should be studied. We aimed to determine the correlation between the 2D Wilkins and real-time transesophageal three-dimensional (RT3D-TEE) scoring systems. Methods This cross-sectional study was performed on 156 patients with moderate to severe mitral stenosis who were candidates for percutaneous balloon valvuloplasty. To morphologic assessment of mitral valve, patients were examined by 2D-transthoracic echocardiography and RT3D-TEE techniques on the same day. Results A strong association was found between total Wilkins and total RT3D-TEE scores (r = 0.809, p < 0.001). The mean mitral valve area assessed by the 2D and 3D was 1.07 ± 0.25 and 1.03 ± 0.26, respectively, indicating a mean difference of 0.037 cm2 (p = 0.001). We found a strong correlation between the values of mitral valve area assessed by 2D and 3D techniques (r = 0.846, p < 0.001). Conclusion There is a high correlation between the two scoring systems in terms of evaluating dominant morphological features. Partially, mitral valve area overestimation in the 2D-transthoracic echocardiography and its inability to assess commissural involvement as well as its dependence on patient age were exceptions in this study.


Author(s):  
Maria E. Currie ◽  
Ana Luisa Trejos ◽  
Reiza Rayman ◽  
Michael W.A. Chu ◽  
Rajni Patel ◽  
...  

Objective The purpose of this study was to determine the effect of three-dimensional (3D) binocular, stereoscopic, and two-dimensional (2D) monocular visualization on robotics-assisted mitral valve annuloplasty versus conventional techniques in an ex vivo animal model. In addition, we sought to determine whether these effects were consistent between novices and experts in robotics-assisted cardiac surgery. Methods A cardiac surgery test-bed was constructed to measure forces applied during mitral valve annuloplasty. Sutures were passed through the porcine mitral valve annulus by the participants with different levels of experience in robotics-assisted surgery and tied in place using both robotics-assisted and conventional surgery techniques. Results The mean time for both the experts and the novices using 3D visualization was significantly less than that required using 2D vision (P < 0.001). However, there was no significant difference in the maximum force applied by the novices to the mitral valve during suturing (P = 0.7) and suture tying (P = 0.6) using either 2D or 3D visualization. The mean time required and forces applied by both the experts and the novices were significantly less using the conventional surgical technique than when using the robotic system with either 2D or 3D vision (P < 0.001). Conclusions Despite high-quality binocular images, both the experts and the novices applied significantly more force to the cardiac tissue during 3D robotics-assisted mitral valve annuloplasty than during conventional open mitral valve annuloplasty. This finding suggests that 3D visualization does not fully compensate for the absence of haptic feedback in robotics-assisted cardiac surgery.


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