Animal model considerations to evaluate prosthetic tricuspid valve implants.

AIMS

Determining tricuspid valve comparative anatomy and appropriate animal models for preclinical evaluation of prosthetic tricuspid valve implants.

METHODS AND RESULTS

We described and measured 81 heart specimens: 12 humans, 22 dogs, 21 sheep and 26 pigs. Tricuspid annulus circumference varied in humans from 109 to 149 mm, in pigs from 85 to 140 mm, and were ≤125 mm in dogs and sheep. Tricuspid leaflet demarcation in dogs is similar to humans, while in pigs and sheep we observed three distinct leaflets. In humans, sheep and pigs, papillary muscle positions are similar. In dogs they are all based on the septum. A moderator band was observed in all species, but was of consistent thickness only in sheep.

CONCLUSIONS

Sheep and pigs are relevant animal models for evaluating prosthetic tricuspid valve implants. Seventy to 90 kg pigs have a tricuspid annulus size comparable to that in a dilated human heart, but due to possible fast growth leading to sizing incompatibilities, this represents a model for short-term study. Sheep are more stable in size for long term study, however, their tricuspid annulus size is the most similar to that in a healthy, non-dilated human heart. Dogs are not a suitable model due to their significantly different sub-valvular anatomy and smaller size.