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A percutaneous approach to create tricuspid regurgitation in swine: a model for transcatheter tricuspid valve therapy assessment

  • Original Article
  • Artificial Valve
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Abstract

Purpose

The purpose of this study was to develop a simple and effective percutaneous approach to create tricuspid regurgitation in swine.

Methods

Eleven pigs (71.68 ± 7.70 kg, 3 male) were involved in this study. A grasping forceps was introduced into the right ventricle through a steerable sheath under fluoroscopic guidance and used to disrupt the tricuspid valve apparatus by avulsing leaflet or chordae tendineae repeatedly. Transthoracic echocardiography and right ventricular angiography were used to evaluate the degree of tricuspid regurgitation created.

Results

Ten of the 11 pigs (90.91%) achieved severe tricuspid regurgitation and 1 (9.09%) obtained moderate tricuspid regurgitation immediately after the procedure. Heart rate of the pigs significantly increased immediately after tricuspid regurgitation creation compared to baseline (88.64 ± 23.24 vs. 76.00 ± 15.30 bpm, P = 0.02), but recovered to normal level at one month follow-up (77.09 ± 11.97 bpm, P = 0.85). The right atrium, tricuspid valve annulus, and right ventricle dilated obviously one month after tricuspid regurgitation creation (dimension changes: 3.01 ± 0.35 vs. 3.56 ± 0.40 cm, P = 0.02; 2.92 ± 0.36 vs. 3.37 ± 0.39 cm, P = 0.01; 3.06 ± 0.42 vs. 3.60 ± 0.47 cm, P = 0.03 respectively). Autopsy findings showed that rupture of leaflet and/or chordae tendineae finally led to the tricuspid regurgitation.

Conclusions

Severe tricuspid regurgitation can be created by a simple and effective percutaneous approach with a grasping forceps in swine model and right heart dilation can be observed consistently at one-month follow-up. This model will be valuable in pre-clinical studies for developing new tricuspid valve repair or replacement technique to treat severe tricuspid regurgitation.

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Acknowledgements

This study was supported by the National Medical Research Council (Singapore), Clinician Scientist–Individual Research Grant (grant number NMRC/ CIRG/1419/2015).

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Authors and Affiliations

  1. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Qian Yan, Zhi Wei Chan & Jeremy Xian Wei Goh

  2. Department of Cardiac, Thoracic and Vascular Surgery, National University Heart Centre, Singapore, Singapore

    Jimmy Kim Fatt Hon & Julian Chi Leung Wong

  3. Department of Cardiology, National University Heart Centre, NUHS Tower Block Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore

    William Kok-Fai Kong & Edgar Lik Wui Tay

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  1. Qian Yan
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  2. Zhi Wei Chan
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  3. Jeremy Xian Wei Goh
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  4. Jimmy Kim Fatt Hon
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Correspondence to Qian Yan or Edgar Lik Wui Tay.

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Yan, Q., Chan, Z.W., Goh, J.X.W. et al. A percutaneous approach to create tricuspid regurgitation in swine: a model for transcatheter tricuspid valve therapy assessment. J Artif Organs 24, 217–224 (2021). https://doi.org/10.1007/s10047-020-01237-1

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  • DOI: https://doi.org/10.1007/s10047-020-01237-1

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