Key result
Tricuspid annuloplasty significantly reduced regurgitation from 3.1 L/min to a clinically mild grade of 1.2 L/min in a novel tissue-hybrid right ventricular pulsatile circulatory simulator.
Why the study?
A pulsatile circulatory simulator with physiological tricuspid valve and right ventricle morphology was hypothesized as essential to evaluate performance following tricuspid valvuloplasty.
Does De-Vega suture annuloplasty reduce regurgitation in a novel tissue-hybrid right ventricular pulsatile circulatory simulator with functional tricuspid regurgitation?
Does De-Vega suture annuloplasty reduce regurgitation in a novel tissue-hybrid right ventricular pulsatile circulatory simulator with functional tricuspid regurgitation?
The novel tissue-hybrid right ventricular circulatory simulator successfully simulated severe functional tricuspid regurgitation and quantitatively demonstrated the efficacy of tricuspid annuloplasty in reducing regurgitation.
May enable controlled in vitro testing of tricuspid annuloplasty; leaves open clinical translation pending validation.
We hypothesize that the development of a pulsatile circulatory simulator with physiological morphology of tricuspid valve (TV) and right ventricle is essential to evaluate the performance after tricuspid valvuloplasty. This study aimed to develop a tissue-hybrid pulsatile circulatory simulator with clinically relevant tricuspid regurgitation (TR) to evaluate the effects of tricuspid annuloplasty. The tissue-silicone hybrid model consisted of a porcine TV sutured to a silicone right ventricular model with enlarged annulus, which can be pulsated while maintaining the relative position between the TV annulus and papillary muscle. The annulus of porcine TV was enlarged by degrading collagen fibers (pre- and post- annular perimeter 115.7 ± 5.5 vs. 133.1 ± 8.2 mm; p = 0.036). Severe TR models were successfully produced (pre- and post- regurgitation 0.64 ± 0.22 vs. 3.1 ± 0.59 L/min p = 0.0002). After the TV annuloplasty, regurgitation was reduced to a clinically mild grade (pre- and post-regurgitation 3.1 ± 0.59 vs 1.2 ± 0.27 L/min p = 0.013). The regurgitant jet in TR models was remarkably reduced after the annuloplasty. The novel tissue-hybrid system was useful to simulate severe TR and quantify the effects of the annuloplasty. The simulator would be useful to evaluate efficacy of emerging medical treatments and optimize them.
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Takada et al. (2022) studied Functional tricuspid regurgitation (in vitro model) (n=12). Tricuspid annuloplasty (De-Vega suture) vs. Pre-annuloplasty TR model was evaluated on Regurgitation (backflow rate) in L/min (p=0.013). Tricuspid annuloplasty significantly reduced regurgitation from 3.1 L/min to a clinically mild grade of 1.2 L/min in a novel tissue-hybrid right ventricular pulsatile circulatory simulator.
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