Utility of the Visible Heart® and Micro-CT Imaging to Optimize the Treatments of Bifurcation Stenting
2021-05
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Utility of the Visible Heart® and Micro-CT Imaging to Optimize the Treatments of Bifurcation Stenting
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2021-05
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Abstract
Using the Visible Heart® Apparatus and methodologies allows for the ability to reanimate large mammalian hearts, including human, and thus to perform bifurcation stenting in an in vitro
setting. This allows for novel uses of multimodal imaging for assessing/testing previous, current
and future clinical recommendations for bifurcation techniques, without risking a living patient.
After performing such procedures, high resolution 3D models were obtained via micro-CT
imaging, which then allows for post implant device/tissue interface analyses. Utilizing
reanimated swine hearts, we were able to uniquely visualize how the various bifurcation
techniques performed could be optimized in specific anatomies. These findings again confirm
that the Visible Heart® Apparatus is a valuable platform that should be used to further understand
how next generation stents and/or bifurcation techniques can best be utilized. Recently, our laboratory also had the privilege to perform bifurcation stenting within three reanimated human hearts using the same methodologies. Additionally, similar PCI procedures
were performed in three perfusion-fixed human hearts as further means to compare the
differences in stenting technique and to identify potential differences between procedures
performed in fixed versus reanimated human hearts. Also, it was identified that after the formalin
fixation process, desecrations of the coronary vessels could readily be induced in healthy human
hearts, while those presenting with coronary artery disease elicited little to no effects due to the
plaque formations. If this holds true, this will open the Visible Heart® Laboratories’ human heart
library of over 580 specimens, to perform clinically relevant bifurcation stenting techniques. Finally, a novel research method of detecting stent malappositions was created, as the current standard for intracoronary imaging, optical coherence tomography (OCT), has its limitations
when there are multiple stents implanted. This method was then used alongside OCT in a step-by
-step bifurcation intervention performed in a formalin fixed human heart. It was shown that stent
apposition continuously improves if the operator adheres to the latest published guidelines; however
future investigations should be performed in more diseased human hearts from the Visible Heart’s
human heart library to focus on other bifurcation techniques and the consequences of straying from
these guidelines in each case.
Description
University of Minnesota Ph.D. dissertation. 2021. Major: Biomedical Engineering. Advisor: Paul Iaizzo. 1 computer file (PDF); 197 pages.
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Valenzuela, Thomas. (2021). Utility of the Visible Heart® and Micro-CT Imaging to Optimize the Treatments of Bifurcation Stenting. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/241335.
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