title: A new approach to the interventional therapy of tricuspid regurgitation.
abstract: Currently, there are no fully developed interventional approaches for the treatment of tricuspid regurgitation (TR). The aim of this study was to evaluate the feasibility of orthotopic interventional placement of a biological prosthetic valve in the tricuspid position by inserting, with a transvenous approach, a self-expandable valve-bearing stent into the right atrium. Based on findings of computerized tomography (CT), a model of the porcine right heart was obtained. A self-expanding vascular endoprosthesis, carrying a prosthetic heart valve, was reshaped to fit the superior vena cava and the tricuspid annulus. Fenestrations were created to allow blood flow from the inferior vena cava and coronary sinus. This new device ("tricuspid endoprosthesis": TE) was implanted operatively into the superior vena cava, right atrium, and tricuspid annulus in six pigs. CT demonstrated proper fitting of the device, and echocardiography demonstrated correct positioning and function of the TE. Five animals were successfully weaned from cardiopulmonary bypass. Autopsy confirmed correct positioning of the TE without major trauma to surrounding tissues. These findings demonstrate a complete interventional approach for treating TR.
authors.affiliation: Clinic for Cardiothoracic Surgery, University Hospital RWTH Aachen, Pauwelsstr 30, D-52074 Aachen, Germany. aamerini@ukaachen.de
authors.forename: Andrea Luigi
authors.initials: AL
authors.lastname: Amerini
authors.forename: Margarita
authors.initials: M
authors.lastname: Malasa
authors.forename: Nima
authors.initials: N
authors.lastname: Hatam
authors.forename: Yara
authors.initials: Y
authors.lastname: Safi
authors.forename: Ulrich
authors.initials: U
authors.lastname: Steinseifer
authors.forename: Andreas
authors.initials: A
authors.lastname: Mahnken
authors.forename: Andreas
authors.initials: A
authors.lastname: Goetzenich
authors.forename: Marcus
authors.initials: M
authors.lastname: Haushofer
authors.forename: Martin
authors.initials: M
authors.lastname: Hildinger
authors.forename: Rudiger
authors.initials: R
authors.lastname: Autschbach
authors.forename: Angelo
authors.initials: A
authors.lastname: Carpi
authors.forename: Jan Wilhelm
authors.initials: JW
authors.lastname: Spillner
mesh_terms: D000818:Animals; D004452:Echocardiography; D006325:Heart Atria / Q000601:surgery; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D008955:Models, Cardiovascular; D013552:Swine; D014057:Tomography, X-Ray Computed; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*