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Annulus Tension on the Tricuspid Valve: An In-Vitro Study

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Abstract

Annulus tension (AT) is defined as leaflet tension per unit length of the annulus circumference. AT was investigated to understand tricuspid valve (TV) annulus mechanics. Ten porcine TVs were mounted on a right ventricle rig with an annulus plate to simulate TV closure. The TVs were mounted on the annulus plate in a normal and dilated TV annulus sizes, and closed under transvalvular pressure of 40 mmHg with the annulus held peripherally by wires. Anterior papillary muscle (PM) and septal PM were displaced in the dilated annulus. Wire forces were measured, and ATs (N/m) were calculated. Clover repair was performed in the dilated TV state subsequently, and AT was calculated again. A one-way ANOVA and Tukey’s HSD test were used to test significances between the different TV states along each annulus segment with p < 0.05. Average ATs for the normal annulus, dilated annulus, and clover repair were 10.75 ± 1.87, 28.81 ± 10.51, and 26.93 ± 11.44 N/m, respectively. Septal annulus segments had the highest ATs when compared to the other segments. For the clover repair, there were no significant changes in AT values. ATs and leaflet forces increased roughly 3–4 times with annulus dilation. AT decelerates annulus dilation as previously shown in the mitral valve. Clover repair does not prevent further annulus dilation by AT change and should be accompanied by annuloplasty. AT improves annulus contraction during a cardiac cycle and should be considered when designing annuloplasty in the future.

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Acknowledgements

The pig hearts were donated by the Klemke Sausage Haus in Slaton, Texas, USA. The authors would like to thank the ARCS Foundation for their generous support. The authors would also like to thank Philip Henry for providing assistance with construction of the normal and dilated annulus plates.

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Authors and Affiliations

  1. Department of Mechanical Engineering, Texas Tech University, 2703 7th street, PO Box 41021, Lubbock, TX, 79409-1021, USA

    Avik Basu & Zhaoming He

  2. Research Center of Fluid Machinery Engineering & Technology, Jiangsu University, Zhenjiang, Jiangsu, 212013, People’s Republic of China

    Zhaoming He

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  1. Avik Basu
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Correspondence to Zhaoming He.

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Associate Editor Ajit P. Yoganathan oversaw the review of this article.

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Basu, A., He, Z. Annulus Tension on the Tricuspid Valve: An In-Vitro Study. Cardiovasc Eng Tech 7, 270–279 (2016). https://doi.org/10.1007/s13239-016-0267-9

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