Mechanical Properties and Composition of the Basal Leaflet-Annulus Region of the Tricuspid Valve

Basu, Avik; Lacerda, Carla M. R.; He, Zhaoming

doi:10.1007/s13239-018-0343-4

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…This distinction was assumed to translate to significantly different stiffnesses and thus dynamics throughout the cardiac cycle. Hiro et al's finding may indicate that the higher stiffness of the lateral annulus is overcome by a larger contractile force of the septum, thus, resulting in similar annular shortening despite varying degrees of stiffness …”

Section: Dynamics Of the Tricuspid Annulussupporting

confidence: 70%

“…Hiro et al's finding may indicate that the higher stiffness of the lateral annulus is overcome by a larger contractile force of the septum, thus, resulting in similar annular shortening despite varying degrees of stiffness. [54] F I G U R E 7 Mean values of engineering metrics of annular dynamics between nine sheep projected onto a spatially aligned and averaged annulus at end-diastole (ED), end-isovolumetric contraction (EIVC), end-systole (ES), and end-isovolumetric relaxation (EIVR), relative to ED. Relative height measures the relative change in the normal distance of the annulus to its best-fit plane throughout the cardiac cycle in reference to the height profile at ED.…”

Section: The Normal 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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Section: Dynamics Of the Tricuspid Annulussupporting

confidence: 70%

Section: The Normal Annulusmentioning

confidence: 99%

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

2019

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“…16 The least responsive portion of the TA to inotropic stimulation was the septal region, with strain of only -2% after calcium infusion. These findings may be explained by high stiffness of this segment due to its dense collagen content, 27 although the septal annulus has previously been shown to be equally susceptible to annular dilation as other regions. 7,14 Because the left ventricle was unloaded in our experimental preparation, it is feasible that septal contribution to annular dynamics was reduced by diminished interventricular interaction.…”

Section: Discussionmentioning

confidence: 94%

Sonomicrometry-derived 3-dimensional geometry of the human tricuspid annulus

Malinowski

Jaźwiec

Goehler

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objectives: Surgical correction of functional tricuspid regurgitation is focused on prosthetic reduction and remodeling of the tricuspid annulus. We set out to investigate the precise geometry of the human tricuspid annulus to better guide surgical therapy.Methods: Eleven human donor hearts with normal right ventricular function and without tricuspid regurgitation that were rejected for clinical transplantation were harvested. Sonomicrometry crystals were sewn around the tricuspid annulus and pressure sensors placed in the right ventricle and right atrium. The hearts were studied in the TransMedics Organ Care System (Andover, Mass) ex vivo perfusion apparatus in the right heart working model. Data were acquired at baseline and before and after bolus calcium infusion. Annular height, dimensions, strain, and curvature were calculated based on 3-dimensional crystal coordinates.Results: Maximal annular area was 997 AE 258 mm 2 and minimal 902 AE 257 mm 2 with contraction of 10% AE 5% at baseline and 19% AE 6% after calcium (P ¼ .007). Segmental contractility of anterior, posterior, and septal annular regions was 7% AE 5%, 6% AE 4%, and 6% AE 3%, respectively. Only anterior region had increased contractility after calcium infusion (to 15% AE 5%; P ¼ .023). Annulus had its high points at anteroseptal commissure and the midposterior region and lowest point in the midseptal region with maximal and minimal height of 5.0 AE 1.1 mm and 4.0 AE 1.1 mm, respectively. The greatest curvature responsible for out of plane annular bending was observed at annular high points. Conclusions:The human tricuspid annulus is a complex 3-dimensional dynamic structure with its high points and maximal degree of bending at the anteroseptal commissure and midposterior annulus. These detailed geometric data may aid the design of more physiologic annular prostheses and surgical reparative techniques.

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“…The septal annulus is composed of collagenous tissue and muscle bundles in the anterior and posterior annulus areas. [ 30 ]…”

Section: Native Valve Propertiesmentioning

confidence: 99%

Transcatheter Heart Valves: A Biomaterials Perspective

Bui

Khair

Yeats

et al. 2021

Adv Healthcare Materials

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Heart valve disease is prevalent throughout the world, and the number of heart valve replacements is expected to increase rapidly in the coming years. Transcatheter heart valve replacement (THVR) provides a safe and minimally invasive means for heart valve replacement in high‐risk patients. The latest clinical data demonstrates that THVR is a practical solution for low‐risk patients. Despite these promising results, there is no long‐term (>20 years) durability data on transcatheter heart valves (THVs), raising concerns about material degeneration and long‐term performance. This review presents a detailed account of the materials development for THVRs. It provides a brief overview of THVR, the native valve properties, the criteria for an ideal THV, and how these devices are tested. A comprehensive review of materials and their applications in THVR, including how these materials are fabricated, prepared, and assembled into THVs is presented, followed by a discussion of current and future THVR biomaterial trends. The field of THVR is proliferating, and this review serves as a guide for understanding the development of THVs from a materials science and engineering perspective.

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Mechanical Properties and Composition of the Basal Leaflet-Annulus Region of the Tricuspid Valve

Cited by 12 publications

References 21 publications

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

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

Sonomicrometry-derived 3-dimensional geometry of the human tricuspid annulus

Transcatheter Heart Valves: A Biomaterials Perspective

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