Department of Modern Mechanical Engineering, School of Creative Science and Engineering, Waseda University, Tokyo, Japan.
Department of Integrative Bioscience and Biomedical Engineering, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.
Sci Rep. 2024 Mar 1;14(1):5120. doi: 10.1038/s41598-024-55058-w.
There is a great demand for development of a functional tricuspid regurgitation (FTR) model for accelerating development and preclinical study of tricuspid interventional repair devices. This study aimed to develop a severe FTR model by creating a tissue-silicone integrated right ventricular pulsatile circulatory simulator. The simulator incorporates the porcine tricuspid annulus, valve leaflets, chordae tendineae, papillary muscles, and right ventricular wall as one continuous piece of tissue, thereby preserving essential anatomical relationships of the tricuspid valve (TV) complex. We dilated the TV annulus with collagenolytic enzymes under applying stepwise dilation, and successfully achieved a severe FTR model with a regurgitant volume of 45 ± 9 mL/beat and a flow jet area of 15.8 ± 2.3 cm (n = 6). Compared to a normal model, the severe FTR model exhibited a larger annular circumference (133.1 ± 8.2 mm vs. 115.7 ± 5.5 mm; p = 0.009) and lower coaptation height (6.6 ± 1.0 mm vs. 17.7 ± 1.3 mm; p = 0.003). Following the De-Vega annular augmentation procedure to the severe FTR model, a significant reduction in regurgitant volume and flow jet area were observed. This severe FTR model may open new avenues for the development and evaluation of transcatheter TV devices.
开发功能性三尖瓣反流（FTR）模型的需求很大，这有助于加速三尖瓣介入修复装置的开发和临床前研究。本研究旨在通过创建组织-硅酮集成右心室脉动循环模拟器来开发严重的 FTR 模型。该模拟器将猪三尖瓣环、瓣叶、腱索、乳头肌和右心室壁整合为一个连续的组织块，从而保留三尖瓣复合体的基本解剖关系。我们用胶原酶扩张三尖瓣环，并逐步扩张，成功地建立了一个反流容积为 45±9mL/次、射流面积为 15.8±2.3cm 的严重 FTR 模型（n=6）。与正常模型相比，严重 FTR 模型的环周长更大（133.1±8.2mm 比 115.7±5.5mm；p=0.009），结合高度更低（6.6±1.0mm 比 17.7±1.3mm；p=0.003）。对严重 FTR 模型进行 De-Vega 环扩大术，反流容积和射流面积明显减少。这种严重的 FTR 模型可能为经导管三尖瓣装置的开发和评估开辟新途径。
