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Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling

1
Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA
2
Institute for Biomedical Engineering, Science and Technology (IBEST), The University of Oklahoma, Norman, OK 73019, USA
3
Department of Biotechnology and Medical Engineering, National Institute of Technology Rourkela, Rourkela, Odisha 769008, India
4
Department of Mechanical Engineering, Iowa State University, Ames, IA 50011, USA
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Glasgow Computational Engineering Centre, School of Engineering, University of Glasgow, Scotland G12 8LT, UK
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Division of Pediatric Cardiology, Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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Division of Cardiothoracic Surgery, Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
8
Advance Magnetic Resonance Center, MS 60, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
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Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA
*
Authors to whom correspondence should be addressed.
Bioengineering 2019, 6(2), 47; https://doi.org/10.3390/bioengineering6020047
Received: 28 April 2019 / Revised: 16 May 2019 / Accepted: 17 May 2019 / Published: 22 May 2019
(This article belongs to the Special Issue Advances in Biological Tissue Biomechanics)
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Abstract

Proper tricuspid valve (TV) function is essential to unidirectional blood flow through the right side of the heart. Alterations to the tricuspid valvular components, such as the TV annulus, may lead to functional tricuspid regurgitation (FTR), where the valve is unable to prevent undesired backflow of blood from the right ventricle into the right atrium during systole. Various treatment options are currently available for FTR; however, research for the tricuspid heart valve, functional tricuspid regurgitation, and the relevant treatment methodologies are limited due to the pervasive expectation among cardiac surgeons and cardiologists that FTR will naturally regress after repair of left-sided heart valve lesions. Recent studies have focused on (i) understanding the function of the TV and the initiation or progression of FTR using both in-vivo and in-vitro methods, (ii) quantifying the biomechanical properties of the tricuspid valve apparatus as well as its surrounding heart tissue, and (iii) performing computational modeling of the TV to provide new insight into its biomechanical and physiological function. This review paper focuses on these advances and summarizes recent research relevant to the TV within the scope of FTR. Moreover, this review also provides future perspectives and extensions critical to enhancing the current understanding of the functioning and remodeling tricuspid valve in both the healthy and pathophysiological states. View Full-Text
Keywords: the tricuspid valve; functional tricuspid regurgitation; cardiovascular imaging; mechanical characterization; in-vitro experiments; constitutive modeling; geometrical modeling; finite element modeling; isogeometric analysis (IGA); biaxial mechanical characterization; fluid-structure interactions; material anisotropy; sub-valvular components the tricuspid valve; functional tricuspid regurgitation; cardiovascular imaging; mechanical characterization; in-vitro experiments; constitutive modeling; geometrical modeling; finite element modeling; isogeometric analysis (IGA); biaxial mechanical characterization; fluid-structure interactions; material anisotropy; sub-valvular components
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Lee, C.-H.; Laurence, D.W.; Ross, C.J.; Kramer, K.E.; Babu, A.R.; Johnson, E.L.; Hsu, M.-C.; Aggarwal, A.; Mir, A.; Burkhart, H.M.; Towner, R.A.; Baumwart, R.; Wu, Y. Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling. Bioengineering 2019, 6, 47.

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