目的系统性评价利用3D打印心脏模型进行先天性心脏病教学的有效性。方法计算机检索PubMed、Web of Science、EMbase数据库中关于3D打印心脏模型应用于先天性心脏病教学的文献,并用Meta分析评估其效果。检索时限为建库至2022年11月10日...目的系统性评价利用3D打印心脏模型进行先天性心脏病教学的有效性。方法计算机检索PubMed、Web of Science、EMbase数据库中关于3D打印心脏模型应用于先天性心脏病教学的文献,并用Meta分析评估其效果。检索时限为建库至2022年11月10日。两位研究者独立筛选文献、提取数据和评价文献质量。随机对照试验质量评价采用Cochrane文献评价标准,横断面和队列研究采用JBI评价量表。使用R软件进行Meta分析。结果筛选后纳入23篇文献,其中随机对照试验7篇、横断面研究15篇、队列研究1篇。随机对照试验均为低风险偏倚,横断面研究和队列研究均存在潜在偏倚。3D打印心脏模型与2D图像教学比较的文献有4篇,其Meta分析结果显示,两组对理论成绩的影响差异有统计学意义[SMD=0.31,95%CI(–0.28,0.91),P=0.05]。结论3D打印心脏模型对先天性心脏病教学效果有一定的促进作用,但未来仍需要更多随机对照试验提供相关证据。展开更多
Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR)...Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR),has yielded mixed results with some patients recover RV function and some do not.An innovative surgical approach was proposed to help ventricle to contract and improve RV function qualified by ejection fraction with one or more active contracting bands.Computational biomechanical modelling is a widely used method in cardiovascular study for investigation of mechanisms governing disease development,quantitative diagnostic and treatment strategies and improving surgical designs for better outcome.Muscle active contraction caused by zero-load sarcomere shortening leads to change of zero-load configurations.In lieu of experimenting using real surgery on animal or human,computational simulations(virtual surgery)were performed to test different band combination and insertion options to identify optimal surgery design and band insertion plan.Methods Cardiac magnetic resonance(CMR)data were obtained from one rTOF patient(sex:male,age:22.5 y)before pulmonary valve replacement surgery.The patient was suffering from RV dilation and dysfunction with RV end-systole volume 254.49ml and end-diastole volume 406.91 mL.A total of 15 computational RV/LV/Patch/Band combination models based on(CMR)imaging were constructed to investigate the influence of different band insertion surgery plans.These models included 5 different band insertion models combined and 3 different band contraction ratio(10%,15%and 20%band zero-stress length reduction).These models included 5 different band insertion models:Model 1 with one band at anterior to the middle of papillary muscle;Model 2 with one band at posterior to the middle of papillary muscle;Model 3 with 2 bands which are the ones from Models 1&2 combined;Model 4 with a band at the base of the papillary muscle;Model 5 with 3 bands which is a combination of Models 3&4.A pre-shrink 展开更多
文摘目的系统性评价利用3D打印心脏模型进行先天性心脏病教学的有效性。方法计算机检索PubMed、Web of Science、EMbase数据库中关于3D打印心脏模型应用于先天性心脏病教学的文献,并用Meta分析评估其效果。检索时限为建库至2022年11月10日。两位研究者独立筛选文献、提取数据和评价文献质量。随机对照试验质量评价采用Cochrane文献评价标准,横断面和队列研究采用JBI评价量表。使用R软件进行Meta分析。结果筛选后纳入23篇文献,其中随机对照试验7篇、横断面研究15篇、队列研究1篇。随机对照试验均为低风险偏倚,横断面研究和队列研究均存在潜在偏倚。3D打印心脏模型与2D图像教学比较的文献有4篇,其Meta分析结果显示,两组对理论成绩的影响差异有统计学意义[SMD=0.31,95%CI(–0.28,0.91),P=0.05]。结论3D打印心脏模型对先天性心脏病教学效果有一定的促进作用,但未来仍需要更多随机对照试验提供相关证据。
基金supported in part by National Sciences Foundation of China grants ( 11672001, 81571691,81771844)
文摘Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR),has yielded mixed results with some patients recover RV function and some do not.An innovative surgical approach was proposed to help ventricle to contract and improve RV function qualified by ejection fraction with one or more active contracting bands.Computational biomechanical modelling is a widely used method in cardiovascular study for investigation of mechanisms governing disease development,quantitative diagnostic and treatment strategies and improving surgical designs for better outcome.Muscle active contraction caused by zero-load sarcomere shortening leads to change of zero-load configurations.In lieu of experimenting using real surgery on animal or human,computational simulations(virtual surgery)were performed to test different band combination and insertion options to identify optimal surgery design and band insertion plan.Methods Cardiac magnetic resonance(CMR)data were obtained from one rTOF patient(sex:male,age:22.5 y)before pulmonary valve replacement surgery.The patient was suffering from RV dilation and dysfunction with RV end-systole volume 254.49ml and end-diastole volume 406.91 mL.A total of 15 computational RV/LV/Patch/Band combination models based on(CMR)imaging were constructed to investigate the influence of different band insertion surgery plans.These models included 5 different band insertion models combined and 3 different band contraction ratio(10%,15%and 20%band zero-stress length reduction).These models included 5 different band insertion models:Model 1 with one band at anterior to the middle of papillary muscle;Model 2 with one band at posterior to the middle of papillary muscle;Model 3 with 2 bands which are the ones from Models 1&2 combined;Model 4 with a band at the base of the papillary muscle;Model 5 with 3 bands which is a combination of Models 3&4.A pre-shrink
