3D打印在经导管封堵治疗心脏瓣周漏中的作用研究进展
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摘要
心脏人工瓣膜瓣周漏是瓣膜置换术后特有的较严重并发症,常需手术治疗,但创伤及风险较大。经导管封堵术是治疗瓣周漏的常用方法,但易引起溶血、肾功能损害等并发症。3D打印是将计算机三维成像技术和多层次连续打印技术相结合的一种新兴技术,可直观显示病变内部解剖结构,帮助诊断疾病和选择治疗方案,已应用于口腔科、骨科、血管外科等疾病的诊治。本文就3D打印在经导管封堵术治疗心脏瓣周漏中的作用研究进展作一综述。
Paravalvular leakage of prosthetic heart valve,a special serious complication after valve replacement,usually requires surgical treatment,but the trauma is large and the risk is high.Transcatheter closure is a common method for paravalvular leakage,but it might cause the complications as hemolysis and renal damage.Combining computer 3D imaging technology and multi-level continuous printing technology,the noval 3D printing technology can visualize the internal anatomy of the lesion,help to make diagnosis and select the treatment options.It has been used in the diagnosis and treatment of the diseases concerning dentistry,orthopedics and vascular surgery.This paper reviews the research progress of 3 Dprinting technology in the treatment of paravalvular leakage of prosthetic heart valve.
Paravalvular leakage of prosthetic heart valve,a special serious complication after valve replacement,usually requires surgical treatment,but the trauma is large and the risk is high.Transcatheter closure is a common method for paravalvular leakage,but it might cause the complications as hemolysis and renal damage.Combining computer 3D imaging technology and multi-level continuous printing technology,the noval 3D printing technology can visualize the internal anatomy of the lesion,help to make diagnosis and select the treatment options.It has been used in the diagnosis and treatment of the diseases concerning dentistry,orthopedics and vascular surgery.This paper reviews the research progress of 3 Dprinting technology in the treatment of paravalvular leakage of prosthetic heart valve.
引文
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[14]邱伯雍,王永霞.慢性心力衰竭流行病学及防治研究进展[J].中华实用诊断与治疗杂志,2017,31(6):619-621.
[15]尚小珂,肖书娜,周红梅,等.肺动脉高压与心律失常[J].中华实用诊断与治疗杂志,2015,29(1):1-4.
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[18]王承,潘欣,张卫,等.经胸小切口导管封堵治疗二尖瓣置换术后瓣周漏[J].中华胸心血管外科杂志,2012,28(4):248-250.
[19]黄功成,舒礼良,黄辰,等.人工瓣膜瓣周漏的治疗[J].中华胸心血管外科杂志,2016,32(4):245-246.
[20]李晓峰,刘洋,陈文生,等.15例主动脉瓣周漏的介入治疗[J].中华胸心血管外科杂志,2015,31(12):748-751.
[21]杨剑,刘洋,唐嘉佑,等.瓣周漏的微创介入治疗[J].中国循环杂志,2016,31(1):74.
[22]KIM M S,HANSGEN A R,WINK O,et al.Rapid prototyping:a new tool in understanding and treating structural heart disease[J].Circulation,2008,117(18):2388-2394.
[23]RIPLEY B,KELIL T,CHEEZUM M K,et al.3Dprinting based on cardiac CT assists anatomic visualization prior to transcatheter aortic valve replacement[J].J Cardiovasc Comput Tomogr,2015,10(1):28-36.
[24]QIAN Z,WANG K,LIU S,et al.Quantitative prediction of paravalvular leak in transcatheter aortic valve replacement based on tissue-mimicking 3Dprinting[J].JACC Cardiovasc Imaging,2017,10(7):719-731.
[25]NISHIMURA R A,OTTO C M,BONOW R O,et al.2014AHA/ACC guideline for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Thorac Cardiovasc Surg,2014,148(1):e1-e132.
[2]李华民,张建卿,王庆志.三维重建与3D打印技术在小儿法洛四联症诊疗中应用[J].中华实用诊断与治疗杂志,2018,32(4):347-348.
[3]刘刚,王承.人工心脏瓣膜置换术后瓣周漏的介入治疗研究进展[J].中国心血管病研究,2017,15(1):4-6.
[4]KASPAROVA M,GRAFOVA L,DVORAK P,et al.Possibility of reconstruction of dental plaster cast from 3Ddigital study models[J].Biomed Eng Online,2013,12(49):1-11.
[5]刘泽,赵建勇.3D打印技术在骨科临床应用中的研究现状[J].河北医药,2017,39(2):288-293.
[6]TAM M D,LAYCOCK S D,JAYNE D,et al.3-D printouts of the tracheobronchial tree generated from CT images as an aid to management in a case of tracheobronchial chondromalacia caused by relapsing polychondritis[J].Radiol Case,2013,7(8):34-43.
[7]KANZAKI M,KIKKAWA T,SHIMIZU T,et al.Presurgical planning using a three-dimensional pulmonary model of the actual anatomy of patient with primary lung cancer[J].Thorac Cardiovasc Surg,2013,61(2):144-150.
[8]KLEIN G T,LU Y,WANG M Y.3D printing and neurosurgery:ready for prime time?[J].World Neurosurg,2013,80(3/4):233-235.
[9]KHAN I,KELLY P,SINGER R.Prototyping of cerebral vasculature physical models[J].Surg Neurol Int,2014,5:11.
[10]赵力运,范太兵.3D打印技术在先天性心脏病诊治中应用进展[J].中华实用诊断与治疗杂志,2017,31(4):410-412.
[11]HUANG T Q,XIN Q,LIU J,et al.3Dprinting of biomimetic microstructures for cancer cell migration[J].Biomed Microdevices,2014,16(1):127-132.
[12]RUIZ C E,JELNIN V,KRONZON I,et al.Clinical outcomes in patients undergoing percutaneous closure of periprosthetic paravalvular leaks[J].J Am Coll Cardiol,2011,58(21):2210-2217.
[13]KIM M S,CASSERLY I P,GARCIA J A,et al.Percutaneous transcatheter closure of prosthetic mitral paravalvular leaks:are we there yet?[J].JACC Cardiovasc Interv,2009,2(2):81-90.
[14]邱伯雍,王永霞.慢性心力衰竭流行病学及防治研究进展[J].中华实用诊断与治疗杂志,2017,31(6):619-621.
[15]尚小珂,肖书娜,周红梅,等.肺动脉高压与心律失常[J].中华实用诊断与治疗杂志,2015,29(1):1-4.
[16]GENONI M,FRANZEN D,TAVAKOLI R,et al.Does the morphology of mitral paravalvular leaks influence symptoms and hemolysis?[J].J Heart Valve Dis,2001,10(4):426-430.
[17]HOURIHAN M,PERRY S B,MANDELL V S,et al.Transcatheter umbrella closure of valvular and paravalvular leaks[J].J Am Coll Cardiol,1992,20(6):1371-1377.
[18]王承,潘欣,张卫,等.经胸小切口导管封堵治疗二尖瓣置换术后瓣周漏[J].中华胸心血管外科杂志,2012,28(4):248-250.
[19]黄功成,舒礼良,黄辰,等.人工瓣膜瓣周漏的治疗[J].中华胸心血管外科杂志,2016,32(4):245-246.
[20]李晓峰,刘洋,陈文生,等.15例主动脉瓣周漏的介入治疗[J].中华胸心血管外科杂志,2015,31(12):748-751.
[21]杨剑,刘洋,唐嘉佑,等.瓣周漏的微创介入治疗[J].中国循环杂志,2016,31(1):74.
[22]KIM M S,HANSGEN A R,WINK O,et al.Rapid prototyping:a new tool in understanding and treating structural heart disease[J].Circulation,2008,117(18):2388-2394.
[23]RIPLEY B,KELIL T,CHEEZUM M K,et al.3Dprinting based on cardiac CT assists anatomic visualization prior to transcatheter aortic valve replacement[J].J Cardiovasc Comput Tomogr,2015,10(1):28-36.
[24]QIAN Z,WANG K,LIU S,et al.Quantitative prediction of paravalvular leak in transcatheter aortic valve replacement based on tissue-mimicking 3Dprinting[J].JACC Cardiovasc Imaging,2017,10(7):719-731.
[25]NISHIMURA R A,OTTO C M,BONOW R O,et al.2014AHA/ACC guideline for the management of patients with valvular heart disease:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J].J Thorac Cardiovasc Surg,2014,148(1):e1-e132.