{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:02:06Z","timestamp":1753876926521,"version":"3.41.2"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Institute of Health","award":["R01HL165251","R21HL161832"],"award-info":[{"award-number":["R01HL165251","R21HL161832"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Ring annuloplasty represents the standard surgical treatment, but offers suboptimal results in patients with severe functional tricuspid regurgitation. Addition of papillary muscles (PMs) approximation may improve clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Eight healthy adult male sheep (56\u2009\u00b1\u20094 kg) underwent cardiopulmonary bypass and implantation of sonomicrometry crystals on the tricuspid annulus, PM tips and right ventricular (RV) free wall. Papillary muscles approximation sutures were anchored between anterior\u2013posterior and anterior\u2013septal PMs and their loose ends externalized through RV free wall to epicardial tourniquets. After weaning from cardiopulmonary bypass, acute right heart failure and tricuspid regurgitation were induced, and subsequent sequential anterior\u2013posterior and anterior\u2013septal PM approximations were performed. Echocardiographic, haemodynamic and sonomicrometry data were collected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Tricuspid regurgitation at baseline in eight sheep was none or trace in 3 and mild in 5, and after induction of acute right heart failure increased significantly to moderate in 5, moderately severe in 1 and severe in 2 (P\u2009=\u20090.011). RV pressure increased from 31 [28; 43] to 51 [47; 55] mmHg (P\u2009=\u20090.012). Anterior\u2013posterior PM approximation decreased regurgitation grade to none or trace in 1, mild in 4 and moderate in 3 (P\u2009=\u20090.016) and reduced PM area from 208 [160; 241] to 108 [48; 181] mm2 (P\u2009=\u20090.008), and anterior\u2013posterior PM distance from 18 [16; 20] to 10 [7; 13] mm (P\u2009=\u20090.037). Anterior\u2013septal approximation also significantly reduced PM area but had no effect on regurgitation grade.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Anterior\u2013posterior but not anterior\u2013septal PM approximation alleviated acute ovine tricuspid regurgitation. Selective PM approximation may offer better control of tricuspid regurgitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivad098","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T01:34:21Z","timestamp":1687484061000},"source":"Crossref","is-referenced-by-count":1,"title":["Effect of papillary muscle approximation on acute ovine functional tricuspid regurgitation"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5301-8170","authenticated-orcid":false,"given":"Boguslaw","family":"Gaweda","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, Corewell Health , Grand Rapids, MI, USA"},{"name":"Department of Cardiac Surgery, Clinical District Hospital No. 2, Faculty of Medicine, University of Rzeszow , Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Ja\u017awiec","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Centre for Heart Disease, Medical University of Silesia in Katowice , Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manikantam","family":"Gaddam","sequence":"additional","affiliation":[{"name":"Department of Urology, Stanford University School of Medicine , Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared D","family":"Bush","sequence":"additional","affiliation":[{"name":"Research Department, Corewell Health , Grand Rapids, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"MacDougall","sequence":"additional","affiliation":[{"name":"Research Department, Corewell Health , Grand Rapids, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazimierz","family":"Widenka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Clinical District Hospital No. 2, Faculty of Medicine, University of Rzeszow , Rzeszow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz A","family":"Timek","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Corewell Health , Grand Rapids, MI, USA"},{"name":"Michigan State University, College of Human Medicine , Grand Rapids, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"key":"2023062420541137900_ivad098-B1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1161\/CIRCIMAGING.111.965707","article-title":"Correlates of tricuspid regurgitation as determined by 3D echocardiography: pulmonary arterial pressure, ventricle geometry, annular dilatation, and papillary muscle displacement","volume":"5","author":"Spinner","year":"2012","journal-title":"Circ Cardiovasc 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