飞秒激光切除离体心肌实验研究  

In Vitro Femtosecond Laser Myectomy in a Swine Model

作　　者：谢国政 夏童 段雪晶[3] 李莉[3] 王璞[2] 闫朝武[1] XIE Guozheng;XIA Tong;DUAN Xuejing;LI Li;WANG Pu;YAN Chaowu(Structural Heart Disease Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037;Faculty of Materials and Manufacturing,Institute of Laser Engineering,Beijing University of Technology,Beijing 100124;Department of Pathology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China)

机构地区：[1]国家心血管病中心、中国医学科学院、北京协和医学院、阜外医院结构性心脏病中心,北京市100037 [2]北京工业大学材料与制造学部激光工程研究院,北京市100124 [3]国家心血管病中心、中国医学科学院、北京协和医学院、阜外医院病理科,北京市100037

出　　处：《中国分子心脏病学杂志》2023年第1期5200-5204,共5页Molecular Cardiology of China

基　　金：国家自然科学基金委员会(61975240)。

摘　　要：目的探索飞秒激光在不同重复频率以及平均输出功率组合下体外切除猪心肌的效果。方法调谐飞秒激光的重复频率与平均输出功率,形成20组不同参数组合,分别对新鲜离体猪心进行体外切除实验,并使用光学显微成像系统进行观察,测量切除区域面积、结痂区面积和热损伤区面积。比较不同参数组合下飞秒激光的切除效果并通过病理学检查进行验证。结果20组飞秒激光切除心肌样本中,切除区域总面积为32841.23(15263.22,57532.55)μm^(2)(1119.01~231059.66μm^(2)),结痂区面积为33486.64(13894.10,52697.15)μm^(2)(2111.05~127205.66μm^(2)),热损伤区面积为447444.31(354901.10,734165.18)μm^(2)(59596.94~2211946.79μm^(2)),切除区域深度370.14(321.30,443.53)μm(248.40~545.90μm)。所有切除区域形态规则,边缘光整;激光烧灼处周围心肌细胞胞质嗜酸性增强、肌丝横纹消失,部分心肌细胞空泡变性。其中,功率1.8W结合重复频率600 kHz的参数组合造成的心肌切除区域与周围结痂区面积比值最大(2.25),其切除区域与周围热损伤区面积比值为0.14。结论飞秒激光切除心肌区域形态规则,边缘光整。低功率与中等频率的参数组合造成的周围心肌热损伤最小。Objective To explore the feasibility of in vitro femtosecond laser myectomy in a swine model at different repetition rates and average output power.Methods By continuously tuning the repetition frequency and average output power of femtosecond laser,20 groups of different parameters were obtained.In vitro femtosecond laser myectomy was conducted in swine myocardium.With different parameters of femtosecond laser,the excised area,scab area and heat damage area were compared and further verified pathologically.Results Among 20 groups of in vitro femtosecond laser myectomy,the excised area was 32841.23(15263.22,57532.55)μm^(2)(1119.01-231059.66μm^(2)),the area of scabbed area was 33486.64(13894.10,52697.15)μm^(2)(2111.05-127205.66μm^(2)),the heat damage area was 447444.31(354901.10,734165.18)μm^(2)(59596.94-2211946.79μm^(2)),and the depth of excision area was 370.14(321.30,443.53)μm(248.40-545.90μm).The borderline between excised and surrounding area was regular and smooth.On pathology,the surrounding myocardial cells were characterized by increased eosinophilic cytoplasm,disappearance of myofilaments,and vacuolar degeneration of some myocardium.By the combination of power 1.8W and repetition frequency 600 kHz,the ratio of the excised area to the surrounding scab area was 2.25 and the ratio of the excised area to the surrounding heat damage area was 0.14.Conclusion In a swine model,femtosecond laser myectomy is feasible in vitro with regular and smooth borderline.The combination of low output power and moderate repetition frequency created the minimum thermal damage.

关 键 词：飞秒激光 体外 心肌 肌切除术 

分 类 号：R779.63[医药卫生—眼科]