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In vitro assessment of available coaptation area as a novel metric for the quantification of tricuspid valve coaptation.
MedLine Citation:
PMID:  23313274     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Tricuspid regurgitation (TR) is associated with increased mortality in patients undergoing mitral valve repair. In recent decades, TR has been addressed using annuloplasty concomitantly with mitral valve repair by some surgeons. However, repair efficacy and durability are often suboptimal. Increased understanding of tricuspid valve coaptation and the effects of pathological and repair conditions may be useful to inform future repair design. In the present study, we propose a two-dimensional in vitro technique, available coaptation area (ACA), to quantify the area of each tricuspid leaflet available for coaptation. Preliminary results showed that annular dilatation caused a significant (p<0.05) decrease in anterior leaflet ACA (0.92±0.18cm(2)), and combined annular dilatation and papillary muscle (PM) displacement resulted in a significant decrease in posterior leaflet ACA (0.87±0.15cm(2)). Isolated PM displacement did not have a significant effect on ACA, and the septal leaflet showed no changed in ACA under the conditions tested. In addition to quantifying ACA, our technique allows for the detailed mapping of leaflet coaptation, which may be used to reveal specific sites of malcoaptation on each leaflet. Application of the ACA method in future studies may lead to the development of specialized tricuspid repair strategies and annuloplasty ring designs that target specific regions of the tricuspid valve based on underlying pathological conditions.
Authors:
Joseph R Dolensky; Lauren D C Casa; Andrew W Siefert; Ajit P Yoganathan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  Journal of biomechanics     Volume:  -     ISSN:  1873-2380     ISO Abbreviation:  J Biomech     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Ltd. All rights reserved.
Affiliation:
The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, United States.
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