Tricuspid valve geometry in patients with functional tricuspid regurgitation: A three‐dimensional echocardiographic study

Karamali, Fatemeh; Hosseini, Saeid; Shojaeifard, Maryam; Mohammadi, Kamran; Kaviani, Raheleh; Rezaei, Yousef; Samiei, Niloufar

doi:10.1111/echo.14747

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…The majority of dilation occurred in the septolateral, or minor axis, corresponding to selective dilatation of the free wall of the right ventricle. These patterns are consistent with the geometric Notes: Geometric measurements of the tricuspid valve leaflets in an ex vivo porcine model in its non-diseased (control) and regurgitant (FTR) state as compared to published (clinical) TEE measurements by: a Karamali et al [11] (n=52); or b Florescu et al [12] (n=58). All results are reported as mean (standard deviation).…”

Section: Discussionsupporting

confidence: 75%

“…Abbreviation: FTR: Functional tricuspid regurgitation. Notes: Geometric measurements of the tricuspid valve annulus in an ex vivo porcine model in its non-diseased (control) and regurgitant (FTR) state as compared to published (clinical) TEE measurements by: a Karamali et al [11] (n=52); or b Ton-Nu et al [13] (n=75). All results are reported as mean (standard deviation).…”

Section: Discussionmentioning

confidence: 99%

“…To compare the native geometry of the swine and human tricuspid valve and to validate the FTR model, the ex vivo native and FTR models were compared to publishe transesophageal echocardiographic (TEE) measurements from non-diseased (control) and FTR patients. Publications were selected if their methodology was well-described, and measurements were sampled in planes similar to those described above [11][12][13].…”

Section: Clinical Validationmentioning

confidence: 99%

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Development and validation of an ex vivo porcine model of functional tricuspid regurgitation

Rando,

Quinn,

Larson

et al. 2024

JCTR

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Background and Aim: Ex vivo models of functional tricuspid regurgitation (FTR) are needed for pre-clinical testing of novel surgical and interventional repair strategies, but current options are costly or have not been formally validated. The objective of this research was to create and validate an ex vivo model to test novel repair methods for FTR. Methods: In explanted porcine hearts, the right atrium was excised to visualize the tricuspid valve. The pulmonary artery and aorta were clamped and cannulated, the coronary arteries ligated, and the right and left ventricles statically pressurized with air to 30 mmHg and 120 mmHg, respectively. FTR was induced by increasing right ventricular pressure to 80 mmHg for 3 h, which resulted in progressive tricuspid annular enlargement, right ventricular dilation, papillary muscle displacement, and central tricuspid malcoaptation. A structured light scanner was used to image the 3D topography of the tricuspid valve in both the native and FTR state, and images were exported into scan-to-computer-aided design software, which allowed for high-resolution 3D computational reconstruction. Relevant geometric measurements were sampled including annular circumference and area, major and minor axis diameter, and tenting height, angle, and area. Geometric measurements from the ex vivo model were compared to clinical transthoracic echocardiographic (TTE) measurements using two-sample t-tests. Results: A total of 12 porcine hearts were included in the study. Annular measurements of the native valve were comparable to published TTE data, except for the minor axis diameter, which was shorter in the ex vivo model (2.5 vs. 3.1 cm, P = 0.007). Induction of FTR in the ex vivo model resulted in annular enlargement (FTR vs. native: circumference 13.7 vs.11.8 cm, P = 0.012; area 14 vs. 11 cm2, P = 0.011). Ex vivo leaflet measurements in both the native and FTR model differed from published TTE data, but demonstrated comparable directional changes between the native and regurgitant states, including increased tenting height, area, and volume. Conclusion: The ex vivo pneumatically-pressurized porcine model closely recapitulates the geometry of both the native and regurgitant tricuspid valve complex in humans and holds promise for testing novel FTR repair strategies. Relevance for Patients: Currently available interventions for the tricuspid valve have a risk of permanent conduction abnormalities and are insufficient in addressing tricuspid disease for a subset of patients. This ex vivo model provides a platform for testing of novel interventions that address the deficiencies of current tricuspid therapies.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Validationmentioning

confidence: 99%

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Development and validation of an ex vivo porcine model of functional tricuspid regurgitation

Rando,

Quinn,

Larson

et al. 2024

JCTR

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“…By allowing a more detailed assessment of the tricuspid valve and its subvalvular apparatus, 3D was found to be superior to 2D echocardiography in the evaluation of tricuspid valve pathology. [5,6] An en face view of the tricuspid valve leaflets from both the atrial and ventricular aspects can be obtained by 3D echocardiography, allowing the evaluation of all three leafl ets from the base to the tip, including the posterior leafl et. [7] We also found that interfering lead was a major contributor to post-implantation TR.…”

Section: Discussionmentioning

confidence: 99%

Association between cardiovascular implantable electronic devices and tricuspid regurgitation: a case-control study

Zhang¹,

Chen²,

Zheng³

et al. 2022

World Journal of Emergency Medicine

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“…It can be divided into four main parts: antero- and posterolateral as well as antero- and posteroseptal [ 1 , 3 ]. The geometry of the TVA can be significantly altered by tricuspid regurgitation (TR) [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

The Right Coronary Anatomy and Operative Topography of the Tricuspid Valve Annulus

Piotrowski,

Burysz,

Batko

et al. 2024

JCDD

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Background: The region of the tricuspid valve is an important area for various cardiac interventions. In particular, the spatial relationships between the right coronary artery and the annulus of the tricuspid valve should be considered during surgical interventions. The aim of this study was to provide an accurate description of the clinical anatomy and topography of this region. Methods: We analyzed 107 computed tomography scans (44% female, age 62.1 ± 9.4 years) of the tricuspid valve region. The circumference of the free wall of the tricuspid valve annulus was divided into 13 annular points and measurements were taken at each point. The prevalence of danger zones (distance between artery and annulus less than 2 mm) was also investigated. Results: Danger zones were found in 20.56% of the cases studied. The highest prevalence of danger zones and the smallest distances were found at the annular points of the tricuspid valve located at the posterior insertion of the leaflets, without observed sex-specific differences. Conclusion: The highest risk of iatrogenic damage to the right coronary artery is in the posterior part of the tricuspid valve annulus.

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Tricuspid valve geometry in patients with functional tricuspid regurgitation: A three‐dimensional echocardiographic study

Cited by 3 publications

References 15 publications

Development and validation of an ex vivo porcine model of functional tricuspid regurgitation

Development and validation of an ex vivo porcine model of functional tricuspid regurgitation

Association between cardiovascular implantable electronic devices and tricuspid regurgitation: a case-control study

The Right Coronary Anatomy and Operative Topography of the Tricuspid Valve Annulus

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