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Transatrial intrapericardial tricuspid annuloplasty
Toby Rogers1, Kanishka Ratnayaka2, Merdim Sonmez1
1Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
JACC. Cardiovascular Interventions
|February 24, 2015
Summary
This study demonstrates a new transcatheter tricuspid annuloplasty technique in swine, successfully reducing annular dimensions and functional tricuspid regurgitation (TR) with promising long-term results.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Functional tricuspid regurgitation (TR) is a prevalent condition linked to increased patient morbidity and mortality.
- Current therapeutic options for functional TR are limited, with no established transcatheter repair methods.
- This study introduces a novel transcatheter extracardiac tricuspid annuloplasty device designed for pericardial space deployment.
Purpose of the Study:
- To demonstrate the feasibility of transcatheter device deployment within the pericardial space.
- To modify tricuspid annular dimensions interactively using the novel device.
- To reduce functional tricuspid regurgitation (TR) in a swine model.
Main Methods:
- Transatrial intrapericardial tricuspid annuloplasty (TRAIPTA) was performed in 16 Yorkshire swine.
- Invasive hemodynamics and cardiac magnetic resonance imaging (MRI) were utilized for assessment.
- Intracardiac echocardiography was used to evaluate TR severity in affected animals.
Main Results:
- Pericardial access via right atrial appendage puncture was uncomplicated.
- Significant reductions in tricuspid annular dimensions (49% septal-lateral, 31% anteroposterior) and area (59%) were observed (p < 0.001).
- Tricuspid leaflet coaptation length increased by 53% (p < 0.001), and TR severity was reduced in affected animals.
Conclusions:
- Transatrial intrapericardial tricuspid annuloplasty (TRAIPTA) represents a novel transcatheter extracardiac tricuspid valve repair.
- The procedure allows for interactive modification of tricuspid annulus geometry.
- This technique shows potential for reducing functional TR in an animal model.
