On the Interaction of Natural and Mechanical Heart Valve Leaflets With the Chordae Tendineae

2002 ◽  
Author(s):  
Amber R. Mace ◽  
Pavlos P. Vlachos ◽  
Demetri P. Telionis
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mechanical Heart Valve ◽  
Postoperative Mortality ◽  
Decisive Role ◽  
Flow Dynamics ◽  
Papillary Muscles ◽  
Posterior Leaflet ◽  
Chordae Tendineae ◽  
Atrioventricular Ring

Long before mitral valve replacement (MVR) became a routine operation, physiologic studies indicated that the continuity of mitral leaflets with papillary muscles, chordae tendineae (CT) and the atrioventricular ring may play a decisive role in the function of the left ventricle (LV) [1]. This led Lillehei et al. [2] to establish a procedure whereby the posterior leaflet, its CT and papillary muscles were preserved in MVRs. These and other studies indicated a significant reduction of postoperative mortality compared to conventional MVR. Though developed in the early 1960s by Lillehei, the technique of chordal preservation was not initially accepted. It wasn’t until 1983 that surgeons began to revive the concept of MVR with preservation of the CT. As this technique became more widely known, many clinical studies were performed; however, very few have been conducted which examine the effect of leaflets and CT on flow dynamics.

Mitral regurgitation

2018 ◽  
Author(s):  
Kazem Rahimi
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Papillary Muscles ◽  
Chordae Tendineae

Mitral regurgitation (MR) is the reflux of blood from the left ventricle into the left atrium as a result of dysfunction of the mitral valve. MR can result from abnormalities of any part of the mitral valve apparatus (valve leaflets, annulus, chordae tendineae, and papillary muscles), or dilatation/disease of the left ventricle.

scholarly journals Clinical and morphological features of malformations of the mitral valve complex

2020 ◽  
Vol 25 (1) ◽  
pp. 105-114
Author(s):  
Е. Trysvetava ◽  
O. Yudina
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Clinical Signs ◽  
Morphological Features ◽  
Congenital Disorders ◽  
Papillary Muscles ◽  
Normal Anatomy ◽  
Chordae Tendineae ◽  
Hemodynamic Changes ◽  
Ring Valve

The mitral valve complex is a multicomponent anatomically and functionally coordinated formation, ensuring the activity of the left ventricle and, in general, the heart. Congenital disorders of the structure, quantity, and form of the mitral complex components can be asymptomatic or cause hemodynamic changes that require surgery. Often, clinical signs of mitral complex abnormalities are manifested as mitral stenosis, regurgitation or its combination and contribute to misdiagnosis. To identify the morphological features of abnormalities by echocardiography, it is necessary to know the possible structure aberrations. The article describes the normal anatomy of the mitral valve complex and abnormalities of the fibrous ring, valve leaflets, papillary muscles and chordae tendineae.

scholarly journals Biomechanical-Structural Correlation of Chordae tendineae in Animal Models: A Pilot Study

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1678
Author(s):  
Justyn Gach ◽  
Izabela Janus ◽  
Agnieszka Mackiewicz ◽  
Tomasz Klekiel ◽  
Agnieszka Noszczyk-Nowak
Keyword(s):  
Mitral Valve ◽  
Complex Structure ◽  
Future Research ◽  
Uniaxial Tensile ◽  
Uniaxial Tensile Test ◽  
Histopathological Analysis ◽  
Papillary Muscles ◽  
Chordae Tendineae ◽  
Structural Correlation ◽  
Ring Valve

The mitral valve apparatus is a complex structure consisting of the mitral ring, valve leaflets, papillary muscles and chordae tendineae (CT). The latter are mainly responsible for the mechanical functions of the valve. Our study included investigations of the biomechanical and structural properties of CT collected from canine and porcine hearts, as there are no studies about these properties of canine CT. We performed a static uniaxial tensile test on CT samples and a histopathological analysis in order to examine their microstructure. The results were analyzed to clarify whether the changes in mechanical persistence of chordae tendineae are combined with the alterations in their structure. This study offers clinical insight for future research, allowing for an understanding of the process of chordae tendineae rupture that happens during degenerative mitral valve disease—the most common heart disease in dogs.

scholarly journals Optimizing P2 Neochordal Length and Stability in Mitral Valve Repair With Use of a Polypropylene Loop

2020 ◽  
Vol 47 (3) ◽  
pp. 207-209
Author(s):  
Anil Ozen ◽  
Ertekin Utku Unal ◽  
Hamdi Mehmet Ozbek ◽  
Gorkem Yigit ◽  
Hakki Zafer Iscan
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Severe Mitral Regurgitation ◽  
Posterior Leaflet ◽  
Valve Repair ◽  
Chordae Tendineae ◽  
Optimal Length ◽  
Precise Method ◽  
Artificial Chordae

Determining the optimal length of artificial chordae tendineae and then effectively securing them is a major challenge in mitral valve repair. Our technique for measuring and stabilizing neochordae involves tying a polypropylene suture loop onto the annuloplasty ring. We used this method in 4 patients who had moderate-to-severe mitral regurgitation from degenerative posterior leaflet (P2) prolapse and flail chordae. Results of intraoperative saline tests and postoperative transesophageal echocardiography revealed only mild insufficiency. One month postoperatively, echocardiograms showed trivial regurgitation in all 4 patients. We think that this simple, precise method for adjusting and stabilizing artificial chordae will be advantageous in mitral valve repair.

Biomechanics of the Mitral Valve in Ischemic Heart Disease: Translating From the Bench to the Operating Room

2010 ◽  
Author(s):  
Muralidhar Padala ◽  
Ajit P. Yoganathan
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Mitral Annulus ◽  
Normal Function ◽  
Force Balance ◽  
Papillary Muscles ◽  
Atrioventricular Valve ◽  
Main Components

The Mitral Valve (MV) is the left atrioventricular valve that controls blood flow between the left atrium and the left ventricle (Fig 1A-B). It has four main components: (i) the mitral annulus — a fibromuscular ring at the base of the left atrium and the ventricle; (ii) two collagenous planar leaflets — anterior and posterior; (iii) web of chordae and (iv) two papillary muscles (PM) that are part of the left ventricle (LV). Normal function of the mitral valve involves a delicate force balance between different components of the valve.

Biaxial Compliance Changes of Mitral Valve Leaflets Following Radiofrequency Ablation

2009 ◽  
Author(s):  
Carolyn G. Norwood ◽  
W. David Merryman
Keyword(s):  
Blood Flow ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Posterior Leaflet ◽  
Anterior Leaflet ◽  
Retrograde Blood Flow

The mitral valve (MV), located between the left atrium and left ventricle of the heart, is responsible for preventing retrograde blood flow by closing during systole. There are two MV leaflets, anterior and posterior. The anterior is the larger of the two and semicircular; the posterior leaflet is more rectangular and can be subdivided into three scallops, the middle scallop being the largest in most human hearts. The two leaflets are anchored to the wall of the left ventricle by the chordae tendinae. The MV annulus forms a complete fibrous ring anchored along the anterior leaflet (1).

Impact of Secondary Chordal Cutting on Mitral Valve Closure and Chordal Force Distribution in an Ischemic Dilated Ventricle: Engineering Insight and Clinical Implications

2009 ◽  
Author(s):  
Muralidhar Padala ◽  
Lazarina I. Gyoneva ◽  
Ajit P. Yoganathan
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Mitral Annulus ◽  
Free Edge ◽  
Normal Function ◽  
Force Balance ◽  
Atrioventricular Valve ◽  
Chordae Tendineae ◽  
Main Components

The Mitral Valve (MV) is the left atrioventricular valve that controls blood flow between the left atrium and the left ventricle (Fig 1A-B). It has four main components: (i) the mitral annulus – a fibromuscular ring at the base of the left atrium and the ventricle; (ii) two collagenous planar leaflets – anterior and posterior; (iii) web of chordae tendineae – classified into primary (inserting at the free edge of the leaflet), secondary (inserting into the base of the leaflet), tertiary (inserting into the annulus); and (iv) two papillary muscles that are part of the left ventricle. Normal function of the mitral valve involves a delicate force balance between different components of the valve.

Mitral Valve Replacement with Preservation of Chordae Tendineae and Papillary Muscles

1988 ◽  
Vol 45 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Shigehito Miki ◽  
Kenji Kusuhara ◽  
Yuichi Ueda ◽  
Masashi Komeda ◽  
Yutaka Ohkita ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Papillary Muscles ◽  
Chordae Tendineae

scholarly journals Identification of Human Pathological Mitral Chordae Tendineae Using Polarization-sensitive Optical Coherence Tomography

Sensors ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 543
Author(s):  
Eusebio Real ◽  
José Icardo ◽  
Gaspar Fernández-Barreras ◽  
José Revuelta ◽  
Marta Calvo Díez ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Property ◽  
Mitral Valve ◽  
Diagnostic Marker ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Papillary Muscles ◽  
Optical Coherence ◽  
Collagen Structure ◽  
Chordae Tendineae

Defects of the mitral valve complex imply heart malfunction. The chordae tendineae (CTs) are tendinous strands connecting the mitral and tricuspid valve leaflets to the papillary muscles. These CTs are composed of organized, wavy collagen bundles, making them a strongly birefringent material. Disorder of the collagen structure due to different diseases (rheumatic, degenerative) implies the loss or reduction of tissue birefringence able to be characterized with Polarization Sensitive Optical Coherence Tomography (PS-OCT). PS-OCT is used to discriminate healthy from diseased chords, as the latter must be excised and replaced in clinical conventional interventions. PS-OCT allows to quantify birefringence reduction in human CTs affected by degenerative and rheumatic pathologies. This tissue optical property is proposed as a diagnostic marker for the identification of degradation of tendinous chords to guide intraoperative mitral valve surgery.

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