Morphometric Characterization and Finite Element Modeling of the Physiological Tricuspid Valve

The tricuspid valve (TV) is the right atrio-ventricular valve. The most common TV disease is secondary or functional tricuspid regurgitation (FTR), an important complication of left-sided valvular heart lesions, which frequently persists after mitral and aortic valve operations. FTR is associated with high mortality and morbidity and requires surgical intervention, the preferential solution being TV repair through techniques such as annuloplasty performed during left heart surgery. However, significant residual regurgitation persists or recurs in 10% to 20% after annuloplasty, thus highlighting the incomplete understanding of the underlying mechanisms and the need for deeper insight into TV pathophysiology. At this purpose finite element models (FEMs) could be adopted, as suggested by their effective application to the biomechanical analysis of left heart valves. However, while for those several data are available regarding morphology and tissue mechanical properties, such information is missing for the TV, making it difficult to implement a FEM of the TV.