Document Detail


Posterior mitral leaflet: new anatomical insight and review of nomenclature (mitral valve anatomy).
MedLine Citation:
PMID:  20856135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Previous studies described single components of the mitral valve, but somewhat lacked the spatial analysis of their relationship. Moreover, further information is necessary regarding reconstructive surgery. The current work aimed at in-depth analysis of the anatomy of the posterior mitral leaflet (PML) and its changes due to degenerative disease, completing the already existing anatomical information about PML and proposing a reorganization of the actual terminology.
METHODS: Nine normal PMLs harvested from cadavers have been compared with 12 pathological specimens from partial resection of PML in the course of valve repair in adult patients. Dimensions of smooth and rough surfaces of the PML have been measured and compared and their dimensional relationships have been assessed; the chance of finding chordae tendineae inserting into the smooth, periannular portion of PML as well as their type have been checked. MEDLINE has been searched for the most relevant publications about PML anatomy.
RESULTS: Observation of normal specimens has confirmed the presence of three types of chordae tendineae: marginal, intermediate and basal, but between the last two, there is some of alternative nature. In degenerative mitral valve disease, the rough part is only 13% greater than the smooth one. In collagen degeneration, both parts contribute in more or less equal proportion to the dimensional increase of the middle scallop, so that the ratio between rough and smooth surface is maintained as in normal specimens.
CONCLUSION: This study reorganizes the previously proposed terminology of PML chordae tendineae. The research identifies the complemental and alternative presence of 'strut' and 'basal' chordae of PML, and it specifies the dimensions of the different anatomical components of the leaflet, in particular of the intermediate scallop. The observations give an accurate anatomical reference for the space of mitral reconstruction with minimal functional impact.
Authors:
Uberto Da Col; Enrico Ramoni; Davide Di Lazzaro
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  820-6     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cadaver
Chordae Tendineae / anatomy & histology*,  pathology,  surgery
Heart Valve Diseases / pathology,  surgery
Humans
Italy
Mitral Valve / anatomy & histology*,  pathology,  surgery
Terminology as Topic*

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