Mechanical and biomaterials engineering optimization of complex cardiovascular operations and innovative therapeutics
Abstract/Contents
- Abstract
- Cardiovascular 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.
Description
| Type of resource | text |
|---|---|
| Form | electronic resource; remote; computer; online resource |
| Extent | 1 online resource. |
| Place | California |
| Place | [Stanford, California] |
| Publisher | [Stanford University] |
| Copyright date | 2023; ©2023 |
| Publication date | 2023; 2023 |
| Issuance | monographic |
| Language | English |
Creators/Contributors
| Author | Zhu, Yuanjia |
|---|---|
| Degree supervisor | Woo, Joseph |
| Thesis advisor | Woo, Joseph |
| Thesis advisor | Camarillo, David |
| Thesis advisor | Wu, Joseph Ching-Ming, 1971- |
| Degree committee member | Camarillo, David |
| Degree committee member | Wu, Joseph Ching-Ming, 1971- |
| Associated with | Stanford University, School of Engineering |
| Associated with | Stanford University, Department of Bioengineering |
Subjects
| Genre | Theses |
|---|---|
| Genre | Text |
Bibliographic information
| Statement of responsibility | Yuanjia Zhu. |
|---|---|
| Note | Submitted to the Department of Bioengineering. |
| Thesis | Thesis Ph.D. Stanford University 2023. |
| Location | https://purl.stanford.edu/zd060wy1507 |
Access conditions
- Copyright
- © 2023 by Yuanjia Zhu
- License
- This work is licensed under a Creative Commons Attribution 3.0 Unported license (CC BY).
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