A procedure for the treatment of tricuspid regurgitation through membrane insertion has been developed recently. However, membrane optimization is required to balance treatment effectiveness with valve damage. This optimization must be performed based on hemodynamic analyses, using the computational fluid dynamics method. The objectives of this study were to analyze hemodynamic features and provide guidelines for the patient-specific optimization of membranes. We used the lattice Boltzmann method for the base blood flow solver and the immersed boundary method to analyze the interactions among the membrane, leaflet, and blood flow. Optimization was performed by the membrane’s volume and insertion angle, and the effects of the shape and surface contact angle of the membrane were observed. Among various patient-specific features, the annulus ratio, hematocrit, and age were selected as control variables. Hemodynamic features were classified as features related to treatment effectiveness, including the regurgitant volume, jet area, and pressure gradient, and those related to the valve leaflet thickening risk, including the Reynolds shear stress, turbulent kinetic energy, and vorticity magnitude. Our analysis results revealed that treatment effectiveness and leaflet damage have a tradeoff relationship; nevertheless, optimizing certain features such as the membrane shape or surface treatment can reduce damage.

最近开发了一种通过膜插入治疗三尖瓣反流的程序。然而，需要膜优化来平衡治疗效果和瓣膜损伤。这种优化必须基于血流动力学分析，使用计算流体动力学方法来执行。本研究的目的是分析血流动力学特征并为针对患者的膜优化提供指导。我们使用格子 Boltzmann 方法作为基础血流求解器和浸没边界法来分析膜、瓣叶和血流之间的相互作用。通过膜的体积和插入角进行优化，观察膜的形状和表面接触角的影响。在各种患者特异性特征中，环比，血细胞比容和年龄被选为控制变量。血流动力学特征被归类为与治疗效果相关的特征，包括反流量、喷射面积和压力梯度，以及与瓣叶增厚风险相关的特征，包括雷诺剪切应力、湍流动能和涡度大小。我们的分析结果表明，治疗效果和瓣叶损伤具有权衡关系；尽管如此，优化某些特征，例如膜形状或表面处理，可以减少损坏。包括雷诺剪应力、湍流动能和涡量大小。我们的分析结果表明，治疗效果和瓣叶损伤具有权衡关系；尽管如此，优化某些特征，例如膜形状或表面处理，可以减少损坏。包括雷诺剪应力、湍流动能和涡量大小。我们的分析结果表明，治疗效果和瓣叶损伤具有权衡关系；尽管如此，优化某些特征，例如膜形状或表面处理，可以减少损坏。