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Regional Changes in Leaflet Coaptation Dynamics After Total Tricuspid Reconstruction
Diana M Ropcke1, Christine Ilkjær1, Søren N Skov1
1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
The Annals of Thoracic Surgery
|March 1, 2017
Summary
Stentless extracellular matrix tube grafts successfully reconstructed competent tricuspid valves in pigs. While coaptation geometry differed, leaflet motion and competence were preserved, showing promise for valve repair.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Echocardiography
Background:
- Stentless porcine extracellular matrix tube grafts are a novel approach for tricuspid valve reconstruction.
- Assessing the performance of these grafts compared to native valves is crucial for clinical application.
Purpose of the Study:
- To perform an echocardiographic assessment of native versus tube graft leaflet performance in an acute porcine model.
- To evaluate the efficacy of extracellular matrix tube grafts in tricuspid valve reconstruction.
Main Methods:
- Fourteen pigs were randomized into tube graft (n=7) or native valve preservation (n=7) groups.
- Epicardial echocardiography was used to assess valve function at baseline, post-operation, and after stabilization.
Main Results:
- Tube graft valves demonstrated significantly larger coaptation length, height, and anterior leaflet length compared to native valves.
- Billowing index and tenting height were not significantly different between groups.
- Leaflet excursion angles showed no significant difference, and all valves remained competent with only mild regurgitation in some cases.
Conclusions:
- Extracellular matrix tube grafts can construct a competent tricuspid valve in a porcine model.
- While coaptation geometry differs, the grafts do not compromise leaflet motion or competence, despite a tendency for prolapse.
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