Functional anatomy of right heart valves

2018 ◽  
Author(s):  
Christine Selton-Suty ◽  
Olivier Huttin ◽  
Clément Venner ◽  
Yves Juillière
Keyword(s):  
Tricuspid Valve ◽  
Heart Valves ◽  
Pulmonary Valve ◽  
Functional Anatomy ◽  
Clinical Importance ◽  
Papillary Muscles ◽  
Right Heart ◽  
Sinotubular Junction ◽  
Left And Right ◽  
Saddle Shape

This chapter summarizes the anatomical features of right heart valves. The tricuspid valve usually comprises three leaflets (anterior, septal, and posterior) separated by three commissures (anteroseptal, posteroseptal, and anteroposterior). The tricuspid valve apparatus consists of papillary muscles and chordae with high variability in number, length, shape, and arrangement of papillary muscles. The tricuspid valve leaflets are attached to a fibrous annulus with an ovoid saddle shape. The pulmonary valve and the aortic valve have identical architecture: three cusps (anterior, left, and right) separated by commissures, a fibrous ring, sinuses, and the sinotubular junction. Good knowledge of tricuspid and pulmonary valve functional anatomy is of clinical importance in the understanding of primary and secondary valvular dysfunction and in the development of new surgical and percutaneous therapeutic strategies.

Functional anatomy of right heart valves

ESC CardioMed ◽  
2018 ◽  
pp. 101-106
Author(s):  
Christine Selton-Suty ◽  
Olivier Huttin ◽  
Clément Venner ◽  
Yves Juillière
Keyword(s):  
Tricuspid Valve ◽  
Heart Valves ◽  
Pulmonary Valve ◽  
Functional Anatomy ◽  
Clinical Importance ◽  
Therapeutic Strategies ◽  
Papillary Muscles ◽  
Right Heart ◽  
Left And Right ◽  
Saddle Shape

This chapter summarizes the anatomical features of right heart valves. The tricuspid valve usually comprises three leaflets (anterior, septal, and posterior) separated by three commissures (anteroseptal, posteroseptal, and anteroposterior). The tricuspid valve apparatus consists of papillary muscles and chordae with high variability in number, length, shape, and arrangement of papillary muscles. The tricuspid valve leaflets are attached to a fibrous annulus with an ovoid saddle shape. The pulmonary valve and the aortic valve have identical architecture: three cusps (anterior, left, and right) separated by commissures, a fibrous ring, sinuses, and the sinotubular junction. Good knowledge of tricuspid and pulmonary valve functional anatomy is of clinical importance in the understanding of primary and secondary valvular dysfunction and in the development of new surgical and percutaneous therapeutic strategies.

Functional anatomy of right heart valves

ESC CardioMed ◽  
2018 ◽  
pp. 101-106
Author(s):  
Christine Selton-Suty ◽  
Olivier Huttin ◽  
Clément Venner ◽  
Yves Juillière
Keyword(s):  
Tricuspid Valve ◽  
Heart Valves ◽  
Pulmonary Valve ◽  
Functional Anatomy ◽  
Clinical Importance ◽  
Therapeutic Strategies ◽  
Papillary Muscles ◽  
Right Heart ◽  
Left And Right ◽  
Saddle Shape

This chapter summarizes the anatomical features of right heart valves. The tricuspid valve usually comprises three leaflets (anterior, septal, and posterior) separated by three commissures (anteroseptal, posteroseptal, and anteroposterior). The tricuspid valve apparatus consists of papillary muscles and chordae with high variability in number, length, shape, and arrangement of papillary muscles. The tricuspid valve leaflets are attached to a fibrous annulus with an ovoid saddle shape. The pulmonary valve and the aortic valve have identical architecture: three cusps (anterior, left, and right) separated by commissures, a fibrous ring, sinuses, and the sinotubular junction. Good knowledge of tricuspid and pulmonary valve functional anatomy is of clinical importance in the understanding of primary and secondary valvular dysfunction and in the development of new surgical and percutaneous therapeutic strategies.

The Effect of Pulmonary Hypertension on Tricuspid Valve Coaptation in Normal and Pathologic Valve Geometries: An In Vitro Study

2012 ◽  
Author(s):  
Joseph R. Dolensky ◽  
Lauren D. C. Casa ◽  
Ajit P. Yoganathan
Keyword(s):  
Pulmonary Hypertension ◽  
Tricuspid Valve ◽  
Pathological Condition ◽  
In Vitro Study ◽  
Pulmonary Vasculature ◽  
Papillary Muscles ◽  
Left Heart ◽  
Right Heart ◽  
The Right

Pulmonary hypertension (PHTN) is a pathological condition defined as a mean pulmonary artery pressure (mPAP) greater than 25 mmHg. PHTN can result from a number of lung and heart pathologies, including abnormalities of the pulmonary vasculature, left heart disease, chronic lung disease, and chronic thrombotic disease [1]. Regardless of the cause, the increased afterload on the right heart results in right ventricle (RV) hypertrophy and dilatation and tricuspid regurgitation (TR) [2]. RV dilatation is thought to result in the displacement of the tricuspid valve (TV) papillary muscles (PM) and dilatation of the TV annulus, negatively impacting TV function.

scholarly journals Use of a Melody Pulmonary Valve in Transcatheter Valve-in-Valve Replacement for Tricuspid Valve Bioprosthesis Degeneration

2014 ◽  
Vol 41 (5) ◽  
pp. 511-513 ◽  
Author(s):  
David M. Filsoof ◽  
David F. Snipelisky ◽  
Brian P. Shapiro
Keyword(s):  
Valve Replacement ◽  
Tricuspid Valve ◽  
Heart Valves ◽  
Pulmonary Valve ◽  
Case Reports ◽  
Repeat Surgery ◽  
First Case ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Bioprosthetic heart valves can degenerate and fail over time. Repeat surgery as a means of replacement increases morbidity and mortality rates, and some patients are not candidates for reoperation. A newer treatment, percutaneous transcatheter valve-in-valve implantation, might delay or substitute for invasive procedures. We present the case of a 51-year-old woman, a poor candidate for surgery who had prosthetic tricuspid valve degeneration and stenosis. We successfully performed valve-in-valve placement of a Melody® valve, using a procedure originally intended to treat pulmonary valve conduit obstruction or regurgitation. To our knowledge, this is among the first case reports to describe the use of the Melody pulmonary valve in transcatheter valve-in-valve replacement for prosthetic tricuspid stenosis that was otherwise not correctable. Additional data and longer follow-up periods are necessary to gain an understanding of ideal indications and selection of patients for the percutaneous transcatheter treatment of tricuspid valve stenosis.

scholarly journals P855 Extensive right heart endocarditis in the past

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Dobrzanska ◽  
M Tomaszewski ◽  
R Zarczuk ◽  
A Tomaszewski ◽  
E Czekajska-Chehab
Keyword(s):  
Pulmonary Embolism ◽  
Right Ventricle ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Right Atrium ◽  
Pulmonary Valve ◽  
Pulmonary Trunk ◽  
Right Heart ◽  
Severe Tricuspid Regurgitation ◽  
The Right

Abstract A 38y. old woman was admitted to a Cardiology Department due to increased exertional dyspnea and decreased exercise tolerance. Echocardiography performed in an outpatient setting has found a substantial enlargement of the right ventricle and severe tricuspid regurgitation. Physical examination significantly enlarged liver, pulsation of jugular veins and numerous scars in the pits elbow. ECG sinus rhythm 85 / min. Right axis deviation. LPH. Hypertrophy of the right atrium. QS in V1-V4. Transthoracic and Transesophageal Echocardiography (TTE,TEE) EF 64%, a significant increase in a right heart chambers (RVDD 4.1 cm, severe tricuspid regurgitation with completely disappearing of tricuspid valve ( only part of septal leaflet was present, which was a consequence of pressure equalization between the right atrium and the right ventricle). In addition, it revealed the structure connected with the pulmonary valve leaflet and moving between the right ventricular outflow tract and pulmonary trunk (most probably healed vegetation, 1.2 x 0.5 cm ). Computed tomography (CT) confirmed the significant enlargement of right heart chambers (EDV 335 ml, ESV 143 ml, SV 192 ml, EF ∼ 58%) with displacement of interatrial septum to the left and the flattening of the interventricular septum . Complete destruction of the tricuspid valve leaflets, with the remaining residual part of septal leaflet was observed. The pulmonary valve was connected mobile irregular structure 2,5 cm x 0,5 cm. Laboratory tests revealed a history of cytomegalovirus infection (p / body IgG> 500,000U / ml). Other tests (HIV, hepatitis B, reaction W-R) - were negative. There was no laboratory and clinical signs of active infection at present. Patient demanded to be discharged from the hospital and refused operation. DISCUSSION Echocardiography did not confirm diagnosis of pulmonary hypertension. D-dimer values of 396 ng / ml (normal <500 ng / ml) excluded suspicion of pulmonary embolism. Left ventricular ejection fraction was normal (EF ∼ 64%), BNP reached the value of 153 pg / ml (normal 0-100pg / ml). This case deserves attention because it documents severe right heart endocarditis by the person using drugs intravenously with an extremely rare takeover of both right heart valves and septic pulmonary embolism. Despite such a large morphological change in the heart of a patient remains in a relatively good clinical condition (NYHA class II/ III). The observed structure of the pulmonary trunk should be considered as healed vegetation. In the absence of consent to the surgery the patient is still treated pharmacologically. Abstract P855 Figure. Pic.1

Robotic, totally endoscopic excision of mitral valve papillary fibroelastoma

2021 ◽  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Benign Tumor ◽  
Pulmonary Valve ◽  
Papillary Fibroelastoma ◽  
Robotic Assisted ◽  
Endoscopic Excision ◽  
Rare Benign Tumor ◽  
Sixth Decade

Papillary fibroelastoma is a rare, benign tumor that affects males more frequently than females and that tends to be diagnosed during the fifth or sixth decade of life. It tends to arise on cardiac valves, with the aortic valve being the most frequent location followed by the mitral valve, the tricuspid valve, and the pulmonary valve. We present the case of a robotic-assisted, totally endoscopic excision of a mitral valve papillary fibroelastoma.

scholarly journals Tricuspid Valve Dysplasia in a Dog

2019 ◽  
Vol 47 ◽  
Author(s):  
Gabriela De Carvalho Cid ◽  
Luciano Da Silva Alonso ◽  
Ana Paula De Castro Pires ◽  
Mariana Siqueira d'Avila Taïna Gonçalves ◽  
Taïna Gonçalves ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Right Atrial ◽  
Pulmonary Insufficiency ◽  
Papillary Muscles ◽  
Ventricular Enlargement ◽  
Pathological Findings ◽  
Chordae Tendineae ◽  
Clinicopathological Findings ◽  
The Right

Background: Congenital cardiac diseases are a common cause of death in puppies. Tricuspid valve dysplasia is characterized by thickening and displacement of the leaflets of the tricuspid valve, agenesis of the valves, and incomplete separation of valve components. Papillary muscles may fuse and display shortened or absent chordae tendineae that contribute to tricuspid regurgitation. Diagnostic features of tricuspid valve dysplasia include cardiomegaly with massive right atrium enlargement on thoracic radiography and tricuspid insufficiency on an ultrasound. We aimed to describe clinicopathological findings in a dog (Canis familiaris) with tricuspid dysplasia.Case: We aimed to describe tricuspid valve dysplasia in a dog referred for necropsy at the Anatomical Pathology Sector of The Rural Federal University of Rio de Janeiro, Brazil, with a clinical history of abdominal swelling, dyspnea, cyanosis, ascites, and prostration. Echocardiography and abdominal ultrasound revealed right ventricular enlargement, hepatomegaly, and splenomegaly. Examination of the heart showed prominent enlargement, thickening and dilation of the right chambers, thickening of the tricuspid leaflets, and moderately shortened chordae tendineae. The liver was enlarged, with a nutmeg pattern, and foci of clotting and fibrin adhesions in the lateral right lobule.Discussion: Epidemiological, clinical, and pathological findings were consistent with tricuspid valve dysplasia. Although structural abnormalities of the tricuspid and mitral valves are well known in fetuses and neonates, congenital and secondary tricuspid malformations are rare in dogs. The survival rate is associated with the severity of heart lesions. Tricuspid valve dysplasia is mostly observed in large-breed dogs (>20 kg), particularly in Labrador Retrievers, Boxers, and German Shepherds. Regardless, most dogs with tricuspid valve dysplasia are of a pure-breed, which differs from our findings because our dog was a mongrel. Our dog displayed signs of dyspnea, cyanosis, abdominal swelling, prostration, and enlarged liver and spleen on ultrasound examination. Tricuspid valve dysplasia led to heart enlargement and right congestive heart failure, with consequent ascites, abdominal swelling, weakness, lethargy, jugular venous distension, and hepatomegaly. Overall, the heart showed prominent enlargement, thickening and dilation of the right chambers, thickening of the tricuspid leaflets, and moderately shortened chordae tendineae. The liver had a nutmeg pattern. Tricuspid valve dysplasia is characterized by malformation of the tricuspid valve leaflets, chord tendineae, or papillary muscles. Malformed tricuspid valves are known to result in variable degrees of regurgitation, leading to right atrial overflow and ventricular eccentric hypertrophy. Differential diagnosis includes myocarditis, tricuspid valve endocarditis, tricuspid endocardiosis, tricuspid valve prolapse and right ventricular dysplasia, right ventricular enlargement with tricuspidal regurgitation due to pulmonary insufficiency, and arrhythmogenic right ventricular cardiomyopathy. Signs of heart murmurs (irregular sounds of the heart) on clinical examination may indicate an irregular blood flow pattern, and imaging tests may be necessary for assessing the presence and severity of any lesions. The epidemiologic, clinical, and pathological findings were consistent with those of tricuspid valve dysplasia. 

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