体外循环下二尖瓣修复策略术前精准规划与疗效评估方法研究

Mitral valve repair with extracorporeal circulation is an important method for treatment of mitral regurgitation. As the heart stops beating during the surgery, the surgeons have to plan the mitral valve repair strategy according to their experience, and during the surgery it is difficult for them to evaluate the efficacy of the repaired mitral valve when the heart beats again. Thus, the accuracy of the mitral valve repair faces serious challenge. This project aims at the preoperative precise planning and efficacy evaluation for the strategy of mitral valve repair with extracorporeal circulation, to address the key scientific problems of accurate heart structure and motion analysis, evolution analysis of mitral valve during repair operation and efficacy evaluation of the mitral valve repair strategy in dynamic environment, this project establishes an accurate 3D heart structure and a motion model based on the precise heart segmentation in preoperative 4D medical images; proposes the biomechanics-based tool-tissue interaction modeling method, and realizes the precise preoperative planning of mitral valve repair strategy; proposes the fluid structure interaction model between blood, mitral valve and cardiac wall in dynamic environment to achieve preoperative efficacy evaluation of the mitral valve repair strategy. The research of this project has great clinic significance in realizing precise mitral valve repair with extracorporeal circulation and meanwhile lays the theoretical foundation for the development of virtual reality in the computer-aided diagnosis and treatment of the complex heart disease.

体外循环下二尖瓣修复手术是治疗二尖瓣反流的重要方式。但由于术中心脏处于停跳状态，医生只能依据经验规划二尖瓣修复策略，难以在术中有效评估修复后的二尖瓣在心脏复跳后的功能，这使得手术的精准性面临严重挑战。本项目面向体外循环下二尖瓣修复手术策略术前精准规划与疗效评估，针对动态心脏精准形态和运动规律分析、二尖瓣修复过程中形态结构演变分析、动态环境下二尖瓣修复策略疗效评估关键科学问题，从术前四维医学影像中的心脏精准分割出发，建立高精度三维心脏结构和运动模型，提出基于生物力学的二尖瓣修复器械-组织交互建模方法，实现二尖瓣修复策略的术前精准规划；提出动态环境下血液、二尖瓣及心壁流固耦合模型，实现二尖瓣修复策略的术前疗效评估。本项目的开展对于实现体外循环下精准二尖瓣修复手术具有重要临床意义，同时为虚拟现实在计算机辅助复杂心脏病诊疗领域的发展奠定理论基础。

体外循环下二尖瓣修复手术是治疗二尖瓣反流的重要方式，本项目面向体外循环下二尖瓣修复手术策略术前精准规划与疗效评估，针对动态心脏精准形态和运动规律分析、手术过程中软组织形态结构演变分析、流固耦合动态环境下的手术策略疗效评估关键科学问题，建立高精度三维心脏结构和运动模型，构建基于生物力学的器械-组织交互模型，实现动态环境下血液-软组织流固耦合模型，为实现精准心脏外科手术奠定坚实基础。本项目共发表论文 14 篇，其中 SCI期刊论文8篇，中文核心论文1篇，EI会议论文5篇，申请发明专利4项，授权发明专利3项，培养硕士生3名，达到了预期研究目标。本项目的开展对于实现精准心脏外科手术具有重要临床意义，同时为虚拟现实在计算机辅助复杂心脏病诊疗领域的发展奠定理论基础。