title: Percutaneous establishment of tricuspid regurgitation: an experimental model for transcatheter tricuspid valve replacement.
abstract: BACKGROUND
  Valve replacement or repair is recommended in patients with tricuspid regurgitation when deterioration of their clinical status occurs as a consequence of right ventricular dysfunction. Percutaneous valve replacement was developed in recent years. To investigate the feasibility, effectiveness and long-term results of percutaneous tricuspid valve replacement, an experimental model with tricuspid regurgitation is needed. We developed a simple and reproducible percutaneous approach for the creation of tricuspid regurgitation in sheep.
  
  
  METHODS
  A specially designed grasping forceps were used to grasp chordae tendineae or the tricuspid valve leaflets through a catheter. Transcatheter creation of tricuspid regurgitation was performed on 7 healthy sheep. These sheep were followed up shortly after the procedure and at 6th month post-procedure with echocardiography. Additionally, all the sheep were sacrificed for anatomic evaluation at 6th month after the procedure.
  
  
  RESULTS
  Creation of tricuspid regurgitation was successfully accomplished in all sheep. Necropsy confirmed that damage was done to the tricuspid valve apparatus in all animals (tearing of the anterior leaflet of the tricuspid valve in five animals and posterior leaflet of the tricuspid valve in two animals). At the six-month follow-up, there was no significant increase in the right ventricle dimension and ejection fraction measured by echocardiography. Autopsy examinations demonstrated the tearing of tricuspid valve leaflets.
  
  
  CONCLUSIONS
  The creation of an animal model of tricuspid regurgitation via a percutaneous approach using forceps to sever one or more tricuspid leaflets is feasible and will allow investigation of devices designed replace the tricuspid valve via a percutaneous approach. Despite significant tricuspid regurgitation, the hemodynamics did not change during the follow-up period in this model.
authors.affiliation: Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Bai
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Chen
authors.forename: Gang-Jun
authors.initials: GJ
authors.lastname: Zong
authors.forename: Hai-Bing
authors.initials: HB
authors.lastname: Jiang
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Xian-Xian
authors.initials: XX
authors.lastname: Zhao
authors.forename: Yong-Wen
authors.initials: YW
authors.lastname: Qin
mesh_terms: D000818:Animals; D002404:Catheterization; D004195:Disease Models, Animal; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D008297:Male; D012756:Sheep; D014262:Tricuspid Valve Insufficiency / Q000628:therapy*