Key result
Finite element analysis demonstrated that vessel wall stresses and contact forces imposed by PTMA stents were much higher in the human coronary sinus model than in the porcine model.
Finite element analysis reveals significant biomechanical differences between human and porcine coronary sinus models, suggesting porcine models may underestimate vessel wall stress and stent radial forces for PTMA devices.
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Porcine models may underestimate PTMA stent forces in humans; leaves open need for species-specific validation before clinical translation.
Recent clinical studies of the percutaneous transvenous mitral annuloplasty (PTMA) devices have shown a short-term reduction of mitral regurgitation after implantation. However, adverse events associated with the devices such as compression and perforation of vessel branches, device migration and fracture were reported. In this study, a finite element analysis was carried out to investigate the biomechanical interaction between the proximal anchor stent of a PTMA device and the coronary sinus (CS) vessel in three steps including: (i) the stent release and contact with the CS wall, (ii) the axial pull t the stent connector and (iii) the pressure inflation of the vessel wall. To investigate the impact of the material properties of tissues and stents on the interactive responses, the CS vessel was modelled with human and porcine material properties, and the proximal stent was modelled with two different Nitinol materials with one being stiffer than the other. The results indicated that the vessel wall stresses and contact forces imposed by the stents were much higher in the human model than the porcine model. However, the mechanical differences induced by the two stent types were relatively small. The softer stent exhibited a better fatigue safety factor when deployed in the human model than in the porcine model. These results underscored the importance of the CS tissue mechanical properties. Vessel wall stress and stent radial force obtained in the human model were higher than those obtained in the porcine model, which also brought up questions as to the validity of using the porcine model to assess device mechanical function. The quantification of these biomechanical interactions can offer scientific insight into the development and optimisation of the PTMA device design.
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Pham et al. (2013) studied Mitral regurgitation (PTMA device evaluation). Percutaneous transvenous mitral annuloplasty (PTMA) proximal anchor stent vs. Porcine vs human material properties; stiffer vs softer Nitinol was evaluated on Vessel wall stresses, contact forces, and fatigue safety factor. Finite element analysis demonstrated that vessel wall stresses and contact forces imposed by PTMA stents were much higher in the human coronary sinus model than in the porcine model.
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