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Engineers at the University of Texas at Austin have developed a new, non-invasive technique to simulate heart valve mitral repair with precision levels that are reliable enough to be used clinically. Mitral valve disease (MV) is one of the most common cardiac conditions badociated with the newly diagnosed valve in 5 million Americans each year. If it is not controlled, the disease at MV can result in heart failure and / or stroke. This breakthrough in computer modeling technology allows surgeons to offer patient-specific treatments, which will improve the long-term effectiveness of current medical approaches.
Led by Michael Sacks, professor at the Department of Biomedical Engineering at the Cockrell School of Engineering, the team presented his computer modeling technique for imaging MV leaflets – flaps located at the base of the valve that open and tighten to regulate the blood flow the left atrium to the left ventricle of the heart – in the latest issues of the International Journal of Numerical Methods in Biomedical Engineering and the Annals of Biomedical Engineering.
The MV plays a crucial role in maintaining a healthy blood circulation in the heart, but normal functioning can be compromised in different ways. For example, a heart attack can disrupt the ability to properly close MV leaflets, resulting in blood leaking into the left atrium of the heart. The medical community therefore understands the importance of a healthy function of VK, but there is no consensus on how best to treat common VVM disorders, such as regurgitation, prolapse and stenosis. the mitral valve.
Until now, surgeons did not have precise modeling approaches to predict the best surgical methods to restore the function of the MV.
"Heart valves are very difficult to study, complex structures that move incredibly quickly and are located inside the heart, making them extremely difficult to visualize," said Sacks, who is also director. of the James T. Willerson Cardiovascular Modeling Center. Simulation at the University Institute of Engineering and Computer Science. "Our new computer model provides surgeons with a tool for predicting post-surgery results from only pre-operative data obtained clinically."
Sacks has spent most of his academic career badyzing and modeling the function of heart valves. Recent advances in computer and 3D imaging technologies have allowed Sacks and his team to acquire noninvasive and accurate in vivo (or living) multivariate sheet geometry in patients using 3D echocardiography. real time, a clinical technique based on sound. waves to monitor heart function.
The computer model of the UT team was developed in collaboration with researchers from Penn Medicine and Georgia Tech.
"Our models have combined the complete 3D geometry of the mitral valve in the open state and in the closed state, allowing for an unparalleled level of predictive accuracy," said Sacks. "To model the MV sheets, we then integrated into the MV models the structure and mechanical properties of the internal constituents, such as the collagen fibers constituting the major part of the valve, in order to develop complete, attribute-rich MV models. . "
Several studies have shown significant gaps in the long-term success of current surgical approaches to treat common heart valve diseases. Up to 60% of patients who have had MV regurgitation surgery report recurrence only two years after surgery.
"Cardiac surgeons must choose the best possible treatment for heart valve repair without knowing all the facts," said Dr. Robert Gorman, professor of surgery at the Perelman School of Medicine at the University of Pennsylvania and collaborator key to the study. "Most rely on their own experiences or how they were taught to practice valve repair surgery at the medical school."
Thanks to the new predictive technique of the researchers, surgeons will no longer have to adopt the unique approach for the repair of the MV leaflet.
"The computer modeling tool we have developed will eliminate much of the uncertainty and take into account the specificity of the patient," Gorman said. "It will be transformative for those working in the field."
The next step for Sacks and his research team is to commercialize their technique.
"Once cardiac surgeons have access to this tool in a clinical setting, we anticipate significant improvements in the long-term well-being of patients with mitral valve surgery," he said.
The study was funded by the National Institutes of Health.
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