{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:28:45Z","timestamp":1768451325528,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T00:00:00Z","timestamp":1517875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["Z01\u2010HL006040"],"award-info":[{"award-number":["Z01\u2010HL006040"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["Z01\u2010HL006039"],"award-info":[{"award-number":["Z01\u2010HL006039"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pledget\u2010assisted suture tricuspid valve annuloplasty (PASTA) is a novel technique using marketed equipment to deliver percutaneous trans\u2010annular sutures to create a double\u2010orifice tricuspid valve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Tricuspid regurgitation is a malignant disease with high surgical mortality and no commercially available transcatheter solution in the US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two iterations of PASTA were tested using trans\u2010apical or trans\u2010jugular access in swine. Catheters directed paired coronary guidewires to septal and lateral targets on the tricuspid annulus under fluoroscopic and echocardiographic guidance. Guidewires were electrified to traverse the annular targets and exchanged for pledgeted sutures. The sutures were drawn together and knotted, apposing septal and lateral targets, creating a double orifice tricuspid valve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two pigs underwent PASTA. Annular and chamber dimensions were reduced (annular area, 10.1\u2009\u00b1\u20090.8 cm<jats:sup>2<\/jats:sup> to 3.8\u2009\u00b1\u20091.5 cm<jats:sup>2<\/jats:sup> (na\u00efve) and 13.1\u2009\u00b1\u20091.5 cm<jats:sup>2<\/jats:sup> to 6.2\u2009\u00b1\u20091.0 cm<jats:sup>2<\/jats:sup> (diseased); septal\u2010lateral diameter, 3.9\u2009\u00b1\u20090.3 mm to 1.4\u2009\u00b1\u20090.6 mm (na\u00efve) and 4.4\u2009\u00b1\u20090.4 mm to 1.7\u2009\u00b1\u20091.0 mm (diseased); and right ventricular end\u2010diastolic volume, 94\u2009\u00b1\u200913 ml to 85\u2009\u00b1\u200914 ml (na\u00efve) and 157\u2009\u00b1\u200925 ml to 143\u2009\u00b1\u200920 ml (diseased)). MRI derived tricuspid regurgitation fraction fell from 32\u2009\u00b1\u200912% to 4\u2009\u00b1\u20095%. Results were sustained at 30 days. Pledget pull\u2010through force was five\u2010fold higher (40.6\u2009\u00b1\u200911.7N vs 8.0\u2009\u00b1\u20092.6N, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01) using this strategy compared to single puncture techniques used to anchor current investigational devices. Serious complications were related to apical access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PASTA reduces annular dimensions and tricuspid regurgitation in pigs. It may be cautiously applied to selected patients with severe tricuspid regurgitation and no options. This is the first transcatheter procedure, to our knowledge, to deliver standard pledgeted sutures to repair cardiac pathology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27531","type":"journal-article","created":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T09:13:35Z","timestamp":1517908415000},"source":"Crossref","is-referenced-by-count":29,"title":["Transcatheter pledget\u2010assisted suture tricuspid annuloplasty (PASTA) to create a double\u2010orifice valve"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6099-0753","authenticated-orcid":false,"given":"Jaffar M.","family":"Khan","sequence":"first","affiliation":[{"name":"Cardiovascular Branch Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health Bethesda 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C.","family":"Babaliaros","sequence":"additional","affiliation":[{"name":"Structural Heart and Valve Center, Emory University Hospital Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Paone","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Henry Ford Health System Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv","family":"Ramasawmy","sequence":"additional","affiliation":[{"name":"Cardiovascular Branch Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Cardiovascular Branch Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel 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