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Mechanical and Biomaterials Engineering Optimization of Complex Cardiovascular Operations and Innovative Therapeutics
Mechanical and Biomaterials Engineering Optimization of Complex Cardiovascular Operations ...
Mechanical and Biomaterials Engineering Optimization of Complex Cardiovascular Operations and Innovative Therapeutics

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20260202104747
ISBN  
9798290649641
DDC  
658.15
저자명  
Zhu, Yuanjia.
서명/저자  
Mechanical and Biomaterials Engineering Optimization of Complex Cardiovascular Operations and Innovative Therapeutics
발행사항  
[Sl] : Stanford University, 2023
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2023
형태사항  
458 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-01, Section: B.
주기사항  
Advisor: Woo, Joseph.
학위논문주기  
Thesis (Ph.D.)--Stanford University, 2023.
초록/해제  
요약Cardiovascular disease is the leading cause of death globally. Every year, close to 18 million people succumb to complications of cardiovascular disease. Coronary artery disease and valvular diseases, two of the main types of cardiovascular disease, are both highly prevalent and frequently treated. For valvular heart disease in particular, guidelines continue to evolve to advocate for earlier intervention. Overall, this represents a significant economic burden with over $200 billion each year being spent on cardiovascular disease in the United States.Severely diseased valves require surgical intervention to prevent life-threatening complications. Even though valve replacement has been a mainstay of therapy for decades, choosing between a mechanical or bioprosthetic replacement valve involves committing patients either to lifelong anticoagulation or future reoperation for structural valve deterioration. Valve repair on the other hand is a safe and highly effective strategy that avoids the disadvantages associated with valve replacement. The repaired valve has its native tissue preserved, and it can heal, grow, adapt, and resist infection. New guidelines also continue to advocate for valve repair over replacement whenever possible. However, valve repair techniques have been based primarily upon anatomic principles and guided by appearance and function. The biomechanical foundations for these techniques are unknown and represent a significant unmet need. In fact, a lot of the repair techniques were developed by trial and error. As such, early failure after valve repair still occurs, and long-term repair durability can still be improved. The cardiothoracic surgery department's clinical practice has notoriety in valve repair with high volume of clinical substrate. This provides us with a wealth of opportunity to study this topic.In terms of ischemic cardiovascular disease, the primary therapy focus has been on urgent revascularization via percutaneous coronary intervention or coronary artery bypass grafting. Although these techniques restore macrovascular blood flow, they do not address microvascular malperfusion, metabolism, and dysfunction, all of which can result in cardiomyocyte loss, maladaptive left ventricular remodeling, progression to heart failure, and early mortality. This is a highly significant clinical problem, and there is a huge unmet need to bring the missing substrate back to the ischemic tissues.Our lab developed an innovative 3D-printed left heart simulator which allowed us to use biomechanical engineering tools to investigate valvular disease and analyze surgical repair treatment while collecting quantitative data. Building on this heart simulator technology foundation, this dissertation first details novel aortic and mitral valve disease models and repair techniques, followed by device development for aortic and mitral valve diseases. Finally, by harnessing the power of 3D bioprinting and photosynthetic biologic agents, I summarized photosynthetic biologic therapeutics for the treatment of ischemic cardiovascular disease. The research outlined herein has resulted in a significant clinical impact on intracardiac valve repair and novel therapeutics for ischemic cardiovascular diseases. This work will continue to serve as a foundation for future investigations of clinical therapies with the goal of rapid and safe translation to patient care.
일반주제명  
Funding
일반주제명  
Biomedical materials
일반주제명  
Mitral valve prolapse
일반주제명  
Doppler effect
일반주제명  
Innovations
일반주제명  
Sutures
일반주제명  
Fourier transforms
일반주제명  
Surgery
일반주제명  
Bioengineering
일반주제명  
Coronary vessels
일반주제명  
Cardiomyocytes
일반주제명  
Aortic aneurysms
일반주제명  
Cardiovascular disease
일반주제명  
Hemodynamics
일반주제명  
Design
일반주제명  
Engineering
일반주제명  
Heart
일반주제명  
Ischemia
일반주제명  
Biomechanics
기타저자  
Stanford University.
기본자료저록  
Dissertations Abstracts International. 87-01B.
전자적 위치 및 접속  
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MARC

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■020    ▼a9798290649641
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■035    ▼a(MiAaPQ)Stanfordzd060wy1507
■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a658.15
■1001  ▼aZhu,  Yuanjia.
■24510▼aMechanical  and  Biomaterials  Engineering  Optimization  of  Complex  Cardiovascular  Operations  and  Innovative  Therapeutics
■260    ▼a[Sl]▼bStanford  University▼c2023
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2023
■300    ▼a458  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-01,  Section:  B.
■500    ▼aAdvisor:  Woo,  Joseph.
■5021  ▼aThesis  (Ph.D.)--Stanford  University,  2023.
■520    ▼aCardiovascular  disease  is  the  leading  cause  of  death  globally.  Every  year,  close  to  18  million  people  succumb  to  complications  of  cardiovascular  disease.  Coronary  artery  disease  and  valvular  diseases,  two  of  the  main  types  of  cardiovascular  disease,  are  both  highly  prevalent  and  frequently  treated.  For  valvular  heart  disease  in  particular,  guidelines  continue  to  evolve  to  advocate  for  earlier  intervention.  Overall,  this  represents  a  significant  economic  burden  with  over  $200  billion  each  year  being  spent  on  cardiovascular  disease  in  the  United  States.Severely  diseased  valves  require  surgical  intervention  to  prevent  life-threatening  complications.  Even  though  valve  replacement  has  been  a  mainstay  of  therapy  for  decades,  choosing  between  a  mechanical  or  bioprosthetic  replacement  valve  involves  committing  patients  either  to  lifelong  anticoagulation  or  future  reoperation  for  structural  valve  deterioration.  Valve  repair  on  the  other  hand  is  a  safe  and  highly  effective  strategy  that  avoids  the  disadvantages  associated  with  valve  replacement.  The  repaired  valve  has  its  native  tissue  preserved,  and  it  can  heal,  grow,  adapt,  and  resist  infection.  New  guidelines  also  continue  to  advocate  for  valve  repair  over  replacement  whenever  possible.  However,  valve  repair  techniques  have  been  based  primarily  upon  anatomic  principles  and  guided  by  appearance  and  function.  The  biomechanical  foundations  for  these  techniques  are  unknown  and  represent  a  significant  unmet  need.  In  fact,  a  lot  of  the  repair  techniques  were  developed  by  trial  and  error.  As  such,  early  failure  after  valve  repair  still  occurs,  and  long-term  repair  durability  can  still  be  improved.  The  cardiothoracic  surgery  department's  clinical  practice  has  notoriety  in  valve  repair  with  high  volume  of  clinical  substrate.  This  provides  us  with  a  wealth  of  opportunity  to  study  this  topic.In  terms  of  ischemic  cardiovascular  disease,  the  primary  therapy  focus  has  been  on  urgent  revascularization  via  percutaneous  coronary  intervention  or  coronary  artery  bypass  grafting.  Although  these  techniques  restore  macrovascular  blood  flow,  they  do  not  address  microvascular  malperfusion,  metabolism,  and  dysfunction,  all  of  which  can  result  in  cardiomyocyte  loss,  maladaptive  left  ventricular  remodeling,  progression  to  heart  failure,  and  early  mortality.  This  is  a  highly  significant  clinical  problem,  and  there  is  a  huge  unmet  need  to  bring  the  missing  substrate  back  to  the  ischemic  tissues.Our  lab  developed  an  innovative  3D-printed  left  heart  simulator  which  allowed  us  to  use  biomechanical  engineering  tools  to  investigate  valvular  disease  and  analyze  surgical  repair  treatment  while  collecting  quantitative  data.  Building  on  this  heart  simulator  technology  foundation,  this  dissertation  first  details  novel  aortic  and  mitral  valve  disease  models  and  repair  techniques,  followed  by  device  development  for  aortic  and  mitral  valve  diseases.  Finally,  by  harnessing  the  power  of  3D  bioprinting  and  photosynthetic  biologic  agents,  I  summarized  photosynthetic  biologic  therapeutics  for  the  treatment  of  ischemic  cardiovascular  disease.  The  research  outlined  herein  has  resulted  in  a  significant  clinical  impact  on  intracardiac  valve  repair  and  novel  therapeutics  for  ischemic  cardiovascular  diseases.  This  work  will  continue  to  serve  as  a  foundation  for  future  investigations  of  clinical  therapies  with  the  goal  of  rapid  and  safe  translation  to  patient  care.
■590    ▼aSchool  code:  0212.
■650  4▼aFunding
■650  4▼aBiomedical  materials
■650  4▼aMitral  valve  prolapse
■650  4▼aDoppler  effect
■650  4▼aInnovations
■650  4▼aSutures
■650  4▼aFourier  transforms
■650  4▼aSurgery
■650  4▼aBioengineering
■650  4▼aCoronary  vessels
■650  4▼aCardiomyocytes
■650  4▼aAortic  aneurysms
■650  4▼aCardiovascular  disease
■650  4▼aHemodynamics
■650  4▼aDesign
■650  4▼aEngineering
■650  4▼aHeart
■650  4▼aIschemia
■650  4▼aBiomechanics
■690    ▼a0202
■690    ▼a0389
■690    ▼a0648
■690    ▼a0576
■690    ▼a0537
■71020▼aStanford  University.
■7730  ▼tDissertations  Abstracts  International▼g87-01B.
■790    ▼a0212
■791    ▼aPh.D.
■792    ▼a2023
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17358752▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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