Objective The purpose of this research was to explore the application value of a three-dimensional (3D)-printed heart in surgery for left ventricular outflow tract (LVOT) obstruction. Methods From August 2019 to October 2021, 46 patients with LVOT obstruction underwent surgical treatment at our institution. According to the treatment method, 22 and 24 patients were allocated to the experimental and control groups, respectively. In the experimental group, each patient’s 3D-printed heart model was used for simulated preoperative surgery, and then the Morrow operation was performed. In the control group, only the Morrow operation was performed, without simulated preoperative surgery using a 3D-printed heart model. The intraoperative and postoperative data of patients in the two groups were recorded, and the clinical data of patients were compared between the two groups. Results The operation time, cardiopulmonary bypass time, intraoperative blood loss, hospitalization time, LVOT pressure difference (LVP), postoperative interventricular septal thickness (IST), aortic regurgitation (AR), systolic anterior motion (SAM), and postoperative left ventricular flow velocity (LVFV) were significantly lower in the experimental group than in the control group (P < 0.05). The inner diameter of the left ventricular outflow tract (IDLV) was larger in the experimental group than in the control group (P < 0.05). There was no significant difference in the postoperative ejection fraction, atrioventricular block rate or complication rate between the two groups (P > 0.05). Conclusion A 3D-printed heart model for simulated surgery in vitro is conducive to formulating a more reasonable surgical plan and reducing the trauma and duration of surgery, thereby promoting the recovery and maintenance of the heart.
Background During the eleven years from 2010 to 2021, preliminary statistics have shown that Fuwai Hospital completed 23,571 mechanical valve replacements for various types of valves, and 1139 mechanical valve replacements were performed in Guangyuan First People's Hospital. Only two patients developed valve leaflet escape, so valve leaflet escape is a rare postoperative complication. Case presentation In 2010 and 2021, two patients were selected after they had unilateral leaflet escape after having mechanical valve replacements in Fuwai Hospital of Chinese Academy of Medical Sciences and Guangyuan First People's Hospital. Both patients underwent reoperations with the classic operation and the new bileaflet mechanical prosthetic heart valve was sutured. The treatment of detached single lobe and distal vessel was comprehensively determined, and the condition was treated according to the patient's symptoms, CT results, ultrasound results and other test results, as well as whether this detached lobe caused any abnormal hemodynamics of the distal vessel. The patient with mechanical aortic valve escape completed the 10-year follow-up, and patient with mechanical mitral valve escape completed the 3-month follow-up. there was no thrombosis or hematoma at the embolic site; the patient had no lower limb symptoms. Conclusions The reason for the leaflet escape may be related to the valve design and the leaflet material. If the detached leaflets are damaged and if the distal blood vessels are affected, simultaneous surgical treatment is required. Those patients whose vessels were not damaged by the valve lobe should be carefully monitored.
Objective: Unilateral leaflet shedding is a rare complication. This paper discusses the causes and treatment strategies of unilateral leaflet shedding of bileaflet mechanical prosthetic heart valves after surgery. Methods: This study was a retrospective study that included 1 case of unilateral leaflet shedding after mechanical valve replacement of the aortic valve in Fuwai Hospital in 2010 and 1 case of unilateral leaflet shedding after mechanical valve replacement of the mitral valve in the First People’s Hospital of Guangyuan in 2021. The new mechanical valves were replaced during subsequent surgeries. data were collected, and the patients were followed up for 10 years and 3 months after the operations, respectively. Results: The patient with an aortic valve replacement was a male; the patient with a mitral valve replacement was a female; and they had an average STS risk score of 3.9%. Both patients had severe regurgitation, and the results of the reoperations were satisfactory. After the operations, the echocardiograms showed that there was no regurgitation in either of the valve replacements. There were no changes in the ankle-brachial index (ABI) before and after the operation in either of the two patients, and no complications or deaths occurred during follow-up. Conclusion: The reason for the leaflet sheddings may be related to the valve design and the leaflet materia. If the detached leaflets are damaged and if the distal blood vessels are affected, simultaneous surgical treatment is required. Those patients whose vessels were not damaged by the valve lobe should be carefully monitored.
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