Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair
Background: Transcatheter-based annuloplasty therapies for tricuspid regurgitation have demonstrated significant development over recent years. However, the tricuspid valve and neighboring vasculature and conductive tissue regions can present anatomical and device deployment challenges. This present...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Structural Heart |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2474870622017833 |
| _version_ | 1798031967969607680 |
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| author | Jorge D. Zhingre Sanchez, PhD Paul A. Iaizzo, PhD |
| author_facet | Jorge D. Zhingre Sanchez, PhD Paul A. Iaizzo, PhD |
| author_sort | Jorge D. Zhingre Sanchez, PhD |
| collection | DOAJ |
| description | Background: Transcatheter-based annuloplasty therapies for tricuspid regurgitation have demonstrated significant development over recent years. However, the tricuspid valve and neighboring vasculature and conductive tissue regions can present anatomical and device deployment challenges. This present study investigated the anatomical dimensions and spatial relationships of the cardiac structures essential to percutaneous annuloplasty procedures: the tricuspid annulus (TA), right coronary artery (RCA), and triangle of Koch border region. Methods: Measurements were derived from computational three-dimensional reconstructions of static magnetic resonance imaging scans of perfusion-fixed human hearts (n = 82) with preserved right-sided heart anatomies. This specimen set included heart samples presenting with prediagnosed atrioventricular valvular regurgitation. Results: Our anatomical assessments demonstrated that the TA to RCA proximities were intensified with the presence of atrioventricular valvular regurgitation, compared with healthy heart specimens. The minimal distances were frequently located between the lateral and posterior annular points. This annular region corresponds to the RCA distal segments and posterior descending branch origins. Greater portions and incidences of the RCA coursing parallel or inferior to the TA plane were recorded for these diseased hearts. Patient demographic variables (gender, age, and body mass index) were insignificant determinants of change for a majority of our results. Conclusions: These three-dimensional reconstructions provide insights to guide the development and future iterations of transcatheter tricuspid valve annuloplasty systems with regards to device anchoring, annular geometry, tissue proximities, and implantation considerations. |
| first_indexed | 2024-04-11T20:05:07Z |
| format | Article |
| id | doaj.art-d1aa68081c234e0b95b9232069111e2e |
| institution | Directory Open Access Journal |
| issn | 2474-8706 |
| language | English |
| last_indexed | 2024-04-11T20:05:07Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Structural Heart |
| spelling | doaj.art-d1aa68081c234e0b95b9232069111e2e2022-12-22T04:05:20ZengElsevierStructural Heart2474-87062022-06-0162100033Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty RepairJorge D. Zhingre Sanchez, PhD0Paul A. Iaizzo, PhD1Departments of Surgery and Biomedical Engineering, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, Minnesota, USAAddress correspondence to: Paul A. Iaizzo, PhD, University of Minnesota, B172 Mayo, 420 Delaware St. SE, MMC 195, Minneapolis, MN 55455; Departments of Surgery and Biomedical Engineering, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, Minnesota, USABackground: Transcatheter-based annuloplasty therapies for tricuspid regurgitation have demonstrated significant development over recent years. However, the tricuspid valve and neighboring vasculature and conductive tissue regions can present anatomical and device deployment challenges. This present study investigated the anatomical dimensions and spatial relationships of the cardiac structures essential to percutaneous annuloplasty procedures: the tricuspid annulus (TA), right coronary artery (RCA), and triangle of Koch border region. Methods: Measurements were derived from computational three-dimensional reconstructions of static magnetic resonance imaging scans of perfusion-fixed human hearts (n = 82) with preserved right-sided heart anatomies. This specimen set included heart samples presenting with prediagnosed atrioventricular valvular regurgitation. Results: Our anatomical assessments demonstrated that the TA to RCA proximities were intensified with the presence of atrioventricular valvular regurgitation, compared with healthy heart specimens. The minimal distances were frequently located between the lateral and posterior annular points. This annular region corresponds to the RCA distal segments and posterior descending branch origins. Greater portions and incidences of the RCA coursing parallel or inferior to the TA plane were recorded for these diseased hearts. Patient demographic variables (gender, age, and body mass index) were insignificant determinants of change for a majority of our results. Conclusions: These three-dimensional reconstructions provide insights to guide the development and future iterations of transcatheter tricuspid valve annuloplasty systems with regards to device anchoring, annular geometry, tissue proximities, and implantation considerations.http://www.sciencedirect.com/science/article/pii/S2474870622017833AnnuloplastyRegurgitationRight coronary arteryTranscatheterTricuspid valve |
| spellingShingle | Jorge D. Zhingre Sanchez, PhD Paul A. Iaizzo, PhD Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair Structural Heart Annuloplasty Regurgitation Right coronary artery Transcatheter Tricuspid valve |
| title | Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair |
| title_full | Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair |
| title_fullStr | Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair |
| title_full_unstemmed | Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair |
| title_short | Computationally Assessed 3D Anatomical Proximities and Spatial Relationships Among the Tricuspid Valve Annulus, Right Coronary Artery, and Triangle of Koch: Implications for Transcatheter Tricuspid Annuloplasty Repair |
| title_sort | computationally assessed 3d anatomical proximities and spatial relationships among the tricuspid valve annulus right coronary artery and triangle of koch implications for transcatheter tricuspid annuloplasty repair |
| topic | Annuloplasty Regurgitation Right coronary artery Transcatheter Tricuspid valve |
| url | http://www.sciencedirect.com/science/article/pii/S2474870622017833 |
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