Right ventricular papillary muscle approximation as a novel technique of valve repair for functional tricuspid regurgitation in an ex vivo porcine model.

The Journal of Thoracic and Cardiovascular Surgery
Haruo YamauchiPedro J del Nido

Abstract

Annuloplasty for functional tricuspid regurgitation may sometimes be ineffective because of chamber dilation and valve tethering. This study compared a novel technique, right ventricle (RV)-papillary muscle approximation, with annuloplasty in experimentally-produced tricuspid regurgitation. RVs of isolated porcine hearts (n = 10) were statically pressurized, which led to RV dilation and central tricuspid regurgitation. Regurgitant flow was measured with a saline solution-filled column. The head of the anterior papillary muscle was approximated to 4 points on the ventricular septum. Next, a prosthetic ring was implanted, and then RV-papillary muscle approximation was combined. Tricuspid annular dimension, RV geometry, and tricuspid valve tethering were analyzed with 3-dimensional echocardiography. Tricuspid regurgitation (2270 ± 186 mL/min) was reduced by RV-papillary muscle approximation alone (214 ± 45 mL/min; P < .05) more than by annuloplasty alone (724 ± 166 mL/min; P < .05). Combined RV-papillary muscle approximation and annuloplasty resulted in the least regurgitation (80 ± 39 mL/min). RV-papillary muscle approximation reduced tricuspid septolateral diameter (25%; P < .05), and annular area (23%; P < .05), as did annulopl...Continue Reading

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Citations

Mar 1, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Nawwar Al-Attar, Ulrik Hvass
Nov 13, 2015·Interactive Cardiovascular and Thoracic Surgery·Xu-jing XieHuan-lei Huang
Aug 19, 2014·The Journal of Thoracic and Cardiovascular Surgery·Victor Bautista-HernandezChristopher W Baird
May 17, 2017·Interactive Cardiovascular and Thoracic Surgery·Mohsen Riki-MarishaniAhmad Aghaii-Zade Torabi
Jan 31, 2015·Asian Cardiovascular & Thoracic Annals·Shamsher Singh LohchabNilesh Agrawal
May 4, 2020·International Journal for Numerical Methods in Biomedical Engineering·Devin W LaurenceChung-Hao Lee
Jun 21, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Sachie ShigemitsuTimothy Colen

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