Biomechanical performance of the Bicaval Transcatheter System for the treatment of severe tricuspid regurgitation

Frontiers in Bioengineering and Biotechnology

Bioengineering and Biotechnology

Caterina Gandolfo¹  Stefano Cannata¹  Fabrizio Crascì²  Salvatore Pasta²  Giovanni Gentile³ 

[1] Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy;Department of Engineering, Università degli Studi di Palermo, Palermo, Italy;Department of Research, IRCCS-ISMETT, Palermo, Italy;Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy;

关键词: tricuspid regurgitation;    transcatheter valve therapies;    bicaval valve implantation;    finite-element analysis;    smoothed-particle hydrodynamics;    computational fluid dynamics;   

DOI  :  10.3389/fbioe.2023.1179774

 received in 2023-03-04, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

Introduction: Tricuspid regurgitation (TR) is a relatively common valvular disease, which can result from structural abnormalities of any anatomic part of the tricuspid valve. Severe TR is linked to congestive heart failure and hemodynamic impairment, resulting in high mortality when repaired by elective surgery. This study was undertaken to quantify the structural and hemodynamic performance of the novel Transcatheter Bicaval Valves System (TricValve) percutaneously implanted in the superior vena cava (SVC) and inferior vena cava (IVC) of two patients with severe TR and venous congestion.Methods: After developing the SVC and IVC device models, the contact pressure exerted on the vena cava wall was obtained by computational analysis. Both smoothed-particle hydrodynamics (SPH) and computational fluid dynamics were carried out to quantify caval reflux in the right atrium and the pressure field of pre- and post-TricValve scenarios, respectively.Results: Analysis of contact pressure highlighted the main anchoring area of the SVC device occurring near the SVC device belly, while the IVC device exerted pronounced forces in the device’s proximal and distal parts. SPH-related flow velocities revealed the absence of caval reflux, and a decrease in time-averaged pressure was observed near the SVC and IVC after TricValve implantation.Discussion: Findings demonstrated the potential of computational tools for enhancing our understanding of the biomechanical performance of structural tricuspid valve interventions and improving the way we design next-generation transcatheter therapies to treat the tricuspid valve with heterotopic caval valve implantation.

【 授权许可】

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Copyright © 2023 Crascì, Cannata, Gentile, Gandolfo and Pasta.