Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Tricuspid cusps modeling using pericardial gussets

Authors: R.I. Amiragov, R.M. Muratov, D.V. Britikov, S.I. Babenko

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-1-26-31

UDC: 616.126.46-089.844

Link: Clinical Physiology of Blood Circulaiton. 2018; 15 (1): 26-31

Quote as: Amiragov R.I., Muratov R.M., Britikov D.V., Babenko S.I. Tricuspid cusps modeling using pericardial gussets. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2018; 15 (1): 26–31 (in Russ.). DOI: 10.24022/1814-6910-2018-15-1-26-31

Received / Accepted:  23.10.2017/30.10.2017

Full text:  

Abstract

Objective. Studying the possibility of replacing the tricuspid valve with a pericard.

Material and methods. In the laboratory condition on the pig heart right atrium dissected. According to author’s calculations – the diameter of the fibrous ring is equal to the length of the base of the septal leaflet (a), with a margin of 5 mm, to create commissures and the leaflets bulge. It is believed that the size of the front flap corresponds to the bottom of the meter (c), which would correspond to a+5, with a margin of 5 mm. For the rear flap (b) – a–5, or b=2/3c = c–1/3c. Radius (r) is d/2+5, the length of the chord (L) is (r+5)/3.

Results. The average time required for each valve prosthesis 15±7 minutes. Pericardial patch size needed for tricuspid valve (TV) reconstruction 4±2 cm. Hydraulic probe showed good valve competence in partial or full valve replacement, and sealed suture line (V=80–120 ml water). Neoleaflets are mobile, not narrowing the AV channel, and coaptation area is located below the level of TV annulus.

Conclusion. TV reconstruction with pericardium (autologous or bovine) can be considered as an alternative to valve replacement. This methodology is a full TV cusps replacement can be used in clinical practice.

References

  1. Akinosogloua K., Apostolakisc E., Koutsogiannisd N., Leivaditise V., Charalambos A. Gogos right-sided infective endocarditis: surgical management. Eur. J. Cardiothorac. Surg. 2012. DOI: 10.1093/ejcts/ezs084

  2. Morokuma H., Minato N., Kamohara K., Minematsu N. Three surgical cases of isolated tricuspid valve infective endocarditis. Ann. Thorac. Cardiovasc. Surg. 2010; 16: 134–8.

  3. Ozkara C., Dogan O.F., Furat C. Isolated tricuspid valve infective endocarditis in young drug abusers. World J. Cardiovasc. Dis. 2012; 10: 201–3.

  4. Kuldeep Singh, Mingli Wang, Marco S.A., D’Alessandro D. Valve repair using autologous pericardium in tricuspid valve endocarditis. 2012; 2 (2): 7–9.

  5. Chachques J.C., Vasseur B., Perier P., Balansa J., Chauvaud S., Carpentier A. A rapid method to stabilize biological material for cardiovascular surgery. Ann. N.Y. Acad. Sci. 1988; 529: 184–6.

  6. Liu D., Zhang M., Song B. An alternative technique for tricuspid valve repair using autologous pericardium. J. Card. Surg. 2009; 24 (5): 518–21. DOI: 10.1111/ j.1540-8191.2009

  7. Konstantinov I.E. Total resection and complete reconstruction of the tricuspid valve in acute infective endocarditis. J. Thorac. Cardiovasc. Surg. 2008; 136: 531–2. DOI: 10.1016/j.jtcvs.2007.12.061

  8. Prendergast B.D., Tornos P. Surgery for infective endocarditis who and when? Circulation. 2010; 36: 1141–52.

  9. Chauvaud S., Jebara V., Chachques J.C., el Asmar B., Mihaileanu S., Perier P. et al. Valve extension with glutaraldehyde- preserved autologous pericardium. Results in mitral valve repair. J. Thorac. Cardiovasc. Surg. 1991; 102: 171–7.

  10. Gottardi R., Bialy J., Devyatko E. Midterm follow-up of tricuspid valve reconstruction due to active infective endocarditis. Ann. Thorac. Surg. 2007; 84: 1943–8.

  11. Gasparyan V.C., Galstyan V.S. Total reconstruction of the mitral valve with autopericardium: anatomical study. Asian. Cardiovasc. Thorac. Ann. 2002; 10: 137–40.

  12. Шамсиев Г.А. Инфекционный эндокардит атриовентрикулярных клапанов: Дис. … д-ра мед. наук. М.; 2007. [Shamsiev G.A. Infective endocarditis of the atrioventricular valves: Dr. med. sc. Diss. Moscow; 2007 (in Russ.).]

  13. Муратов Р.М., Хаммуд Ф.А., Соболева Н.Н., Чекаева Т.В., Лазарев Р.А., Логинова Л.И. и др. Пластика трикуспидального клапана при инфекционном эндокардите с реконструкцией створок ксеноперикардиальной заплатой и созданием неохорд из политетрафторэтилена (ПТФЭ). Грудная и сердечно- сосудистая хирургия. 2009; 1: 57–61 [Muratov R.M., Khammud F.A., Soboleva N.N., Chekaeva T.V., Lazarev R.A., Loginova L.I. et al. Plastic of tricuspid valve infectious endocarditis with reconstruction of folds xenopericardial patch and creating neochord of polytetrafluoroethylene (PTFE). Grudnaya i Serdechno- Sosudistaya Khirurgiya (Russian Journal of Thoracic and Cardiovascular Diseases). 2009; 1: 57–61 (in Russ.).]

  14. Амирагов Р.И., Муратов Р.М., Бабенко С.И., Шамсиев Г.А., Бритиков Д.В., Соболева Н.Н. Инфекционный эндокардит с обширным поражением трикуспидального клапана: новый подход к реконструкции с использованием ауто- и ксеноперикарда и неохорд. Анналы хирургии. 2014; 6: 23–30. [Amiragov R.I., Muratov R.M., Babenko S.I., Shamsiev G.A., Britikiv D.V., Soboleva N.N. Infective endocarditis with extensive lesions of the tricuspid valve: a new approach to reconstruction with the use of auto- and xenopericardial band and neochord. Annaly Khirurgii (Annals of Surgery, Russian journal). 2014; 6: 23–30 (in Russ.).]

  15. Duran C.M.G., Gometza B., Kumar N., Gallo R., Martin-Duran R. Aortic valve replacement with freehand autologous pericardium. J. Thorac. Cardiovasc. Surg. 1995; 110: 511–6.

  16. Musci M., Siniawski H., Pasic M. Surgical treatment of right-sided active infective endocarditis with or without involvement of the left heart: 20-year single center experience. Eur. J. Cardiothorac. Surg. 2007; 32: 118–25.

  17. Амирагов Р.И. Экспериментальное обоснование моделирования створок трикуспидального клапана перикардом. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2014; 15 (прил. 6): 305. [Amiragov R.I. Experimental validation of modeling cusps of tricuspid valve to pericardum. Byulleten’ Nauchnogo Tsentra Serdechno-Sosudistoy Khirurgii imeni A.N. Bakuleva Rossiyskoy Academii Meditsinskikh Nauk (Bulletin of A.N. Bakoulev Scientific Center for Cardiovascular Surgery Russian Academiy of Medical Sciences, Russian journal). 2014; 15 (suppl. 6): 305 (in Russ.).]

About Authors

  • Amiragov Roman Ivanovich, Junior Researcher; orcid.org/0000-0001-6459-6788
  • Muratov Ravil’ Muratovich, Dr. Med. Sc., Professor, Head of Department of Emergency Surgery of Acquired Heart Disease; orcid.org/0000-0003-3321-9028
  • Britikov Dmitriy Vyacheslavovich, Dr. Med. Sc., Head of Laboratory of Biotechnology
  • Babenko Svetlana Ivanovna, Cand. Med. Sc., Leading Researcher, Deputy Head of Department of Emergency Surgery of Acquired Heart Disease; orcid.org/0000-0002-2621-4504

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