Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study
There has been a resurgence of interest in the treatment of severe functional tricuspid regurgitation (FTR) due to the awareness of its poor outcomes and potential percutaneous therapies. Kay bicuspidization has been adapted in percutaneous therapies but its clinical outcome remains uncertain. The p...
| Main Authors: | , , , , , |
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
2019
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| Online Access: | https://hdl.handle.net/10356/100061 http://hdl.handle.net/10220/49951 |
| _version_ | 1811696601118277632 |
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| author | Nguyen, Yen Ngoc Kabinejadian, Foad Kong, William Kok-Fai Tay, Edgar Lik Wui Leo, Hwa Liang Munirah Ismail |
| author2 | School of Mechanical and Aerospace Engineering |
| author_facet | School of Mechanical and Aerospace Engineering Nguyen, Yen Ngoc Kabinejadian, Foad Kong, William Kok-Fai Tay, Edgar Lik Wui Leo, Hwa Liang Munirah Ismail |
| author_sort | Nguyen, Yen Ngoc |
| collection | NTU |
| description | There has been a resurgence of interest in the treatment of severe functional tricuspid regurgitation (FTR) due to the awareness of its poor outcomes and potential percutaneous therapies. Kay bicuspidization has been adapted in percutaneous therapies but its clinical outcome remains uncertain. The present study evaluates the efficacy of Kay repair in a novel ex vivo pulsatile system. Porcine tricuspid valve (TV) (n = 3) was extracted and incorporated into a patient-specific silicon right ventricle (RV) emulating severe FTR, on which Kay repair was subsequently performed. TV area metrics and RV hemodynamic assessment by means of stereo-scopic particle image velocimetry were quantified in both FTR and post-repair conditions. Bicuspidization led to significant increase in cardiac output although the overall increment due to this approach alone was generally small, possibly due to existence of residual TR and the large reduction in TV opening area. Kinetic energy and viscous loss levels were increased post-repair, especially during diastolic filling. Main vortex structures generally maintained post-procedural. However, there was enhanced swirling motion in larger RV domain. Although this might reduce mural-thrombus risk, the relatively more complex vortex phenomenon likely resulted in elevated viscous loss observed and may potentially impact long-term adaptation. The RV hemodynamic alteration after tricuspid repair could be used to predict the success of these future transcatheter solutions. |
| first_indexed | 2024-10-01T07:41:57Z |
| format | Journal Article |
| id | ntu-10356/100061 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T07:41:57Z |
| publishDate | 2019 |
| record_format | dspace |
| spelling | ntu-10356/1000612023-03-04T17:14:10Z Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study Nguyen, Yen Ngoc Kabinejadian, Foad Kong, William Kok-Fai Tay, Edgar Lik Wui Leo, Hwa Liang Munirah Ismail School of Mechanical and Aerospace Engineering Biomedical Engineering Cardiac Device Therapy Engineering::Mechanical engineering There has been a resurgence of interest in the treatment of severe functional tricuspid regurgitation (FTR) due to the awareness of its poor outcomes and potential percutaneous therapies. Kay bicuspidization has been adapted in percutaneous therapies but its clinical outcome remains uncertain. The present study evaluates the efficacy of Kay repair in a novel ex vivo pulsatile system. Porcine tricuspid valve (TV) (n = 3) was extracted and incorporated into a patient-specific silicon right ventricle (RV) emulating severe FTR, on which Kay repair was subsequently performed. TV area metrics and RV hemodynamic assessment by means of stereo-scopic particle image velocimetry were quantified in both FTR and post-repair conditions. Bicuspidization led to significant increase in cardiac output although the overall increment due to this approach alone was generally small, possibly due to existence of residual TR and the large reduction in TV opening area. Kinetic energy and viscous loss levels were increased post-repair, especially during diastolic filling. Main vortex structures generally maintained post-procedural. However, there was enhanced swirling motion in larger RV domain. Although this might reduce mural-thrombus risk, the relatively more complex vortex phenomenon likely resulted in elevated viscous loss observed and may potentially impact long-term adaptation. The RV hemodynamic alteration after tricuspid repair could be used to predict the success of these future transcatheter solutions. Published version 2019-09-17T09:27:33Z 2019-12-06T20:15:58Z 2019-09-17T09:27:33Z 2019-12-06T20:15:58Z 2019 Journal Article Nguyen, Y. N., Kabinejadian, F., Munirah Ismail, Kong, W. K.-F., Tay, E. L. W., & Leo, H. L. (2019). Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study. Scientific Reports, 9(1), 11504-. doi:10.1038/s41598-019-47873-3 https://hdl.handle.net/10356/100061 http://hdl.handle.net/10220/49951 10.1038/s41598-019-47873-3 en Scientific Reports © 2019 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. 13 p. application/pdf |
| spellingShingle | Biomedical Engineering Cardiac Device Therapy Engineering::Mechanical engineering Nguyen, Yen Ngoc Kabinejadian, Foad Kong, William Kok-Fai Tay, Edgar Lik Wui Leo, Hwa Liang Munirah Ismail Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study |
| title | Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study |
| title_full | Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study |
| title_fullStr | Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study |
| title_full_unstemmed | Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study |
| title_short | Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study |
| title_sort | ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation a stereo scopic piv study |
| topic | Biomedical Engineering Cardiac Device Therapy Engineering::Mechanical engineering |
| url | https://hdl.handle.net/10356/100061 http://hdl.handle.net/10220/49951 |
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