IMR Press / FBE / Volume 5 / Issue 2 / DOI: 10.2741/E636

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article

A new approach to the interventional therapy of tricuspid regurgitation

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1 Clinic for Cardiothoracic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
2 Applied Medical Engineering (AME), Helmholtz Institute Aachen, Pauwelsstr. 20, D-52074 Aachen, Germany
3 Department of Radiology, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany
4 Department of Reproduction and Ageing, University of Pisa, Via Roma 67, 56126 Pisa, Italy

*Author to whom correspondence should be addressed.

Academic Editor: Angelo Carpi

Front. Biosci. (Elite Ed) 2013, 5(2), 546–550; https://doi.org/10.2741/E636
Published: 1 January 2013
(This article belongs to the Special Issue Advances in bone disease pathophisiology and management)
Abstract

Currently, there are no fully developed interventional approaches for the treatment of tricuspid regurgitation (TR). The aim of this study was to evaluate the feasibility of orthotopic interventional placement of a biological prosthetic valve in the tricuspid position by inserting, with a transvenous approach, a self-expandable valve-bearing stent into the right atrium. Based on findings of computerized tomography (CT), a model of the porcine right heart was obtained. A self-expanding vascular endoprosthesis, carrying a prosthetic heart valve, was reshaped to fit the superior vena cava and the tricuspid annulus. Fenestrations were created to allow blood flow from the inferior vena cava and coronary sinus. This new device (“tricuspid endoprosthesis”: TE) was implanted operatively into the superior vena cava, right atrium, and tricuspid annulus in six pigs. CT demonstrated proper fitting of the device, and echocardiography demonstrated correct positioning and function of the TE. Five animals were successfully weaned from cardiopulmonary bypass. Autopsy confirmed correct positioning of the TE without major trauma to surrounding tissues. These findings demonstrate a complete interventional approach for treating TR.

Keywords
Tricuspid valve
interventional therapy
endovascular procedure
right atrium
atrial stent
load displacement
vena cava
coronary sinus
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