ArticleJTCVS structural and endovascular2026
Acute left ventricular unloading in chronic ovine biventricular failure with functional tricuspid regurgitation.
Article in JTCVS structural and endovascular, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Right ventricular failure and functional tricuspid regurgitation are associated with left ventricular assist device implantation. We set out to investigate the effect of acute left ventricular unloading on right ventricular subvalvular geometry in the setting of ovine biventricular heart failure with functional tricuspid regurgitation. Methods: Seven adult Dorset male sheep underwent left thoracotomy and pacemaker implantation and were paced until the development of biventricular dysfunction and functional tricuspid regurgitation. Subsequently, animals underwent sternotomy and cardiopulmonary bypass for implantation of sonomicrometry crystals around the tricuspid annulus, on each papillary muscle tip, and on the right ventricular epicardium. After weaning from cardiopulmonary bypass, a continuous-flow left ventricular assist device was implanted. Simultaneous hemodynamic, sonomicrometry, and echocardiographic data were acquired before and after full left ventricular unloading. Results: Pacing resulted in a significant increase in left ventricular end-diastolic dimension, tricuspid annular size, and tricuspid and mitral regurgitation. There was a significant reduction in left ventricular ejection fraction (60% ± 6% vs 34% ± 11%, Conclusions: Left ventricular unloading in an ovine model of biventricular failure with tricuspid regurgitation was associated with increased inter-papillary distances and papillary muscle area most likely due to septal shift. These geometric alterations in subvalvular geometry may contribute to valvular insufficiency and right ventricular failure over time.
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