# A tissue-silicone integrated simulator for right ventricular pulsatile circulation with severe functional tricuspid regurgitation

## TL;DR

Researchers created a realistic simulator of a diseased heart valve to test new repair devices and found that a specific treatment reduced the severity of the valve leak.

## Contribution

A novel tissue-silicone integrated simulator was developed to model severe functional tricuspid regurgitation for device testing.

## Key findings

- The severe FTR model had a regurgitant volume of 45 ± 9 mL/beat and a flow jet area of 15.8 ± 2.3 cm².
- The FTR model showed a larger annular circumference and lower coaptation height compared to a normal model.
- De-Vega annular augmentation significantly reduced regurgitant volume and flow jet area in the FTR model.

## Abstract

There is a great demand for development of a functional tricuspid regurgitation (FTR) model for accelerating development and preclinical study of tricuspid interventional repair devices. This study aimed to develop a severe FTR model by creating a tissue-silicone integrated right ventricular pulsatile circulatory simulator. The simulator incorporates the porcine tricuspid annulus, valve leaflets, chordae tendineae, papillary muscles, and right ventricular wall as one continuous piece of tissue, thereby preserving essential anatomical relationships of the tricuspid valve (TV) complex. We dilated the TV annulus with collagenolytic enzymes under applying stepwise dilation, and successfully achieved a severe FTR model with a regurgitant volume of 45 ± 9 mL/beat and a flow jet area of 15.8 ± 2.3 cm2 (n = 6). Compared to a normal model, the severe FTR model exhibited a larger annular circumference (133.1 ± 8.2 mm vs. 115.7 ± 5.5 mm; p = 0.009) and lower coaptation height (6.6 ± 1.0 mm vs. 17.7 ± 1.3 mm; p = 0.003). Following the De-Vega annular augmentation procedure to the severe FTR model, a significant reduction in regurgitant volume and flow jet area were observed. This severe FTR model may open new avenues for the development and evaluation of transcatheter TV devices.