Pulmonary Artery Banding: an Effective in-vivo Acute Model of Functional Tricuspid Regurgitation for Transcatheter Interventions.

Abstract

Tricuspid regurgitation&#xa0;(TR) is a highly morbid and often untreated valvular heart disease. New devices are under development to address this unmet need, necessitating valid models to test their efficacy. Aim of this study was to assess feasibility and reliability of pulmonary artery banding (PAB) as a pathological acute model of functional TR. Eight pigs underwent right thoracotomy, with an umbilical tape placed around the main pulmonary trunk, followed by controlled reduction of the pulmonary artery lumen via a tourniquet system. No animals died during the procedure. After PAB, right ventricular (RV) mean pressure, RV basal and mid-diameter and tricuspid septo-lateral diameter significantly increased (+&#x2009;97%,&#x2009;+&#x2009;23%,&#x2009;+&#x2009;32%,&#x2009;+&#x2009;20%, p&#x2009;<&#x2009;0.01 for all). Consequently, TR was at least moderate-to-severe in all the animals and these modifications remained stable for up to one hour. PAB therefore represents a reliable, one-step model of functional TR ideal to test the efficacy of new tricuspid devices.