Large animal model of acute right ventricular failure with functional tricuspid regurgitation

Malinowski, Marcin; Proudfoot, Alistair G.; Eberhart, Lenora; Schubert, H.; Wodarek, Jeremy; Langholz, David; Rausch, Manuel K.; Timek, Tomasz A.

doi:10.1016/j.ijcard.2018.02.072

Cited by 19 publications

(19 citation statements)

References 35 publications

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“…Models of transient pulmonary artery occlusion increase RV afterload by mechanical constriction of the pulmonary artery from the exterior or by inflation of intravascular balloons (48). External occlusion can be applied by ligature (43,44), snares (42), simple banding (40), or more advanced adjustable bands using air (41,45,46). The occlusion, and hence the PVR and RV strain, can be adjusted very precisely and, as opposed to PE models, the resistance can be reduced or even removed as the occlusion can be re-loosened.…”

Section: Models Of Transient Pulmonary Artery Occlusionmentioning

confidence: 99%

Animal models of right heart failure

Andersen¹,

Feen²,

Andersen³

et al. 2020

Cardiovasc Diagn Ther

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Right heart failure may be the ultimate cause of death in patients with acute or chronic pulmonary hypertension (PH). As PH is often secondary to other cardiovascular diseases, the treatment goal is to target the underlying disease. We do however know, that right heart failure is an independent risk factor, and therefore, treatments that improve right heart function may improve morbidity and mortality in patients with PH. There are no therapies that directly target and support the failing right heart and translation from therapies that improve left heart failure have been unsuccessful, with the exception of mineralocorticoid receptor antagonists. To understand the underlying pathophysiology of right heart failure and to aid in the development of new treatments we need solid animal models that mimic the pathophysiology of human disease. There are several available animal models of acute and chronic PH. They range from flow induced to pressure overload induced right heart failure and have been introduced in both small and large animals.When initiating new pre-clinical or basic research studies it is key to choose the right animal model to ensure successful translation to the clinical setting. Selecting the right animal model for the right study is hence important, but may be difficult due to the plethora of different models and local availability. In this review we provide an overview of the available animal models of acute and chronic right heart failure and discuss the strengths and limitations of the different models.

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Section: Models Of Transient Pulmonary Artery Occlusionmentioning

confidence: 99%

Animal models of right heart failure

Andersen¹,

Feen²,

Andersen³

et al. 2020

Cardiovasc Diagn Ther

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“…Employing the same ovine model, Malinowski et al (2018) [100] also observed the effect of annuloplasty suture on the TV annular mechanics, noting that the tricuspid valve surgical repair resulted in an increase in the compressive TV annular strains. More recently, Mathur et al (2019) [103] refined the approach by placing four sonomicrometery crystals on each of the three TV leaflets and six on the surrounding TV annulus. Through this approach, they observed that the TVAL and TVPL had similar closing patterns, while the TVSL appeared to have a smaller range of motion and closing velocity.…”

Section: In-vivo and In-vitro Investigationsmentioning

confidence: 99%

Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling

et al. 2019

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Proper tricuspid valve (TV) function is essential to unidirectional blood flow through the right side of the heart. Alterations to the tricuspid valvular components, such as the TV annulus, may lead to functional tricuspid regurgitation (FTR), where the valve is unable to prevent undesired backflow of blood from the right ventricle into the right atrium during systole. Various treatment options are currently available for FTR; however, research for the tricuspid heart valve, functional tricuspid regurgitation, and the relevant treatment methodologies are limited due to the pervasive expectation among cardiac surgeons and cardiologists that FTR will naturally regress after repair of left-sided heart valve lesions. Recent studies have focused on (i) understanding the function of the TV and the initiation or progression of FTR using both in-vivo and in-vitro methods, (ii) quantifying the biomechanical properties of the tricuspid valve apparatus as well as its surrounding heart tissue, and (iii) performing computational modeling of the TV to provide new insight into its biomechanical and physiological function. This review paper focuses on these advances and summarizes recent research relevant to the TV within the scope of FTR. Moreover, this review also provides future perspectives and extensions critical to enhancing the current understanding of the functioning and remodeling tricuspid valve in both the healthy and pathophysiological states.

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“…We have previously used both techniques to study the shape and dynamics of the atrioventricular annulus; the former to study the mitral annulus, and the latter to study the shape and dynamics of the tricuspid annulus . Regardless of the technique, the end‐product is the 3D coordinates of the fiduciary markers.…”

Section: Dynamics Of the Tricuspid Annulusmentioning

confidence: 99%

“…We have recently developed several acute tricuspid regurgitation sheep models to study changes in the dynamics of the diseased annulus . In an acute pulmonary hypertension model, for example, we calculated classic clinical metrics of annular dynamics reported in the medical literature, such as annular area, perimeter, height, and eccentricity .…”

Section: Dynamics Of the Tricuspid Annulusmentioning

confidence: 99%

“…We recently performed DeVega suture annuloplasty repairs in sheep with acute functional tricuspid regurgitation induced via pulmonary banding, volume overload, and right ventricular ischemia . Figure illustrates our experimental technique in which we placed pledget‐supported double row sutures along the lateral annulus and externalized those sutures in anesthetized sheep.…”

Section: Dynamics Of the Tricuspid Annulusmentioning

confidence: 99%

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Biomechanics of the tricuspid annulus: A review of the annulus' in vivo dynamics with emphasis on ovine data

2019

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The tricuspid annulus forms the boundary between the tricuspid valve leaflets and their surrounding perivalvular tissue of the right atrioventricular junction. Its shape changes throughout the cardiac cycle in response to the forces from the contracting right heart myocardium and the blood‐valve interaction. Alterations to annular shape and dynamics in disease lead to valvular dysfunctions such as tricuspid regurgitation from which millions of patients suffer. Successful treatment of such dysfunction requires an in‐depth understanding of the normal shape and dynamics of the tricuspid annulus and of the changes following disease and subsequent repair. In this manuscript we review what we know about the shape and dynamics of the normal tricuspid annulus and about the effects of both disease and repair based on noninvasive imaging studies and invasive fiduciary marker‐based studies. We further show, by means of ovine data, that detailed engineering analyses of the tricuspid annulus provide regionally resolved insight into the kinematics of the annulus which would remain hidden if limiting analyses to simple geometric metrics.

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Large animal model of acute right ventricular failure with functional tricuspid regurgitation

Cited by 19 publications

References 35 publications

Animal models of right heart failure

Animal models of right heart failure

Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling

Biomechanics of the tricuspid annulus: A review of the annulus' in vivo dynamics with emphasis on ovine data

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