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Title: Ex vivo assessment of bicuspidization repair in treating severe functional tricuspid regurgitation : a stereo-scopic PIV study
Authors: Nguyen, Yen Ngoc
Kabinejadian, Foad
Kong, William Kok-Fai
Tay, Edgar Lik Wui
Leo, Hwa Liang
Munirah Ismail
Keywords: Biomedical Engineering
Cardiac Device Therapy
Engineering::Mechanical engineering
Issue Date: 2019
Source: 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
Series/Report no.: Scientific Reports
Abstract: 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.
DOI: 10.1038/s41598-019-47873-3
Rights: © 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
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:MAE Journal Articles

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