Laengle Severin, Suria Aldo, Poschner Thomas, Tasdelen Sahra, Pitsis Antonios, Kocher Alfred, Andreas Martin
Department for Cardiac Surgery, Medical University of Vienna, 1090 Vienna, Austria.
European Interbalkan Medical Center, Thessaloniki Heart Institute, 57001 Thessaloniki, Greece.
Bioengineering (Basel). 2024 Jun 29;11(7):666. doi: 10.3390/bioengineering11070666.
Tricuspid regurgitation (TR) is a prevalent finding in echocardiography and in case of severe disease is associated with impaired patient outcome. Clover repair offers a surgical solution that can be applied for the treatment of primary and secondary TR. An ex vivo passive beating porcine heart model was created to test a modified clover technique using automated suturing devices and to compare this approach to standard ring annuloplasty. Secondary TR was induced in 10 porcine hearts and the backflow of fluid was assessed. The primary endpoint of this study was regurgitant volume measured in mL at the site right atrial cannula. The baseline regurgitation was 43.3 ± 10.8 mL. The mean regurgitant volume was significantly reduced after all repair procedures to 22.2 ± 5.9 mL with isolated ring annuloplasty, 12 ± 3.9 mL with the modified clover, and 7.6 ± 3.4 mL with the combined procedure ( < 0.0001). The modified clover technique shows how to effectively reduce TR in an ex vivo model. This method may be suitable to facilitate tricuspid repair, especially for totally endoscopic valve surgery.
三尖瓣反流（TR）是超声心动图检查中常见的发现，严重疾病情况下与患者预后受损相关。三叶草修复术提供了一种可用于治疗原发性和继发性TR的手术解决方案。创建了一个离体被动跳动的猪心脏模型，以测试使用自动缝合装置的改良三叶草技术，并将该方法与标准环成形术进行比较。在10个猪心脏中诱导继发性TR，并评估液体反流情况。本研究的主要终点是以毫升为单位测量右心房插管部位的反流容积。基线反流为43.3±10.8毫升。所有修复手术后，单纯环成形术的平均反流容积显著降低至22.2±5.9毫升，改良三叶草技术为12±3.9毫升，联合手术为7.6±3.4毫升（<0.0001）。改良三叶草技术展示了如何在离体模型中有效减少TR。该方法可能适用于促进三尖瓣修复，特别是对于完全内镜下瓣膜手术。
