作者：Han; Yu; Tal; Geva; Rahul; HRathod; Ch...heartmodelfailuretetralogyoffallotcontractionband
摘要：Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR),has yielded mixed results with some patients recover RV function and some do not.An innovative surgical approach was proposed to help ventricle to contract and improve RV function qualified by ejection fraction with one or more active contracting bands.Computational biomechanical modelling is a widely used method in cardiovascular study for investigation of mechanisms governing disease development,quantitative diagnostic and treatment strategies and improving surgical designs for better outcome.Muscle active contraction caused by zero-load sarcomere shortening leads to change of zero-load configurations.In lieu of experimenting using real surgery on animal or human,computational simulations(virtual surgery)were performed to test different band combination and insertion options to identify optimal surgery design and band insertion plan.Methods Cardiac magnetic resonance(CMR)data were obtained from one rTOF patient(sex:male,age:22.5 y)before pulmonary valve replacement surgery.The patient was suffering from RV dilation and dysfunction with RV end-systole volume 254.49ml and end-diastole volume 406.91 mL.A total of 15 computational RV/LV/Patch/Band combination models based on(CMR)imaging were constructed to investigate the influence of different band insertion surgery plans.These models included 5 different band insertion models combined and 3 different band contraction ratio(10%,15%and 20%band zero-stress length reduction).These models included 5 different band insertion models:Model 1 with one band at anterior to the middle of papillary muscle;Model 2 with one band at posterior to the middle of papillary muscle;Model 3 with 2 bands which are the ones from Models 1&2 combined;Model 4 with a band at the base of the papillary muscle;Model 5 with 3 bands which is a combination of Models 3&4.A pre-shrink
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