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.

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.

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.

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.

scholarly journals The role of subvalvular structures in the development of mitral valve prolapse in children

2012 ◽  
Vol 93 (3) ◽  
pp. 490-493
Author(s):  
Yu M Belozerov ◽  
Sh M Magomedova ◽  
Z S Abakarova ◽  
I M Osmanov
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Valve Prolapse ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Healthy Children ◽  
Papillary Muscles ◽  
Functional Parameters

Aim. To assess the role of subvalvular structures in the development of mitral valve prolapse in children. Methods. Conducted was an echocardiography investigation with comparative analysis of structural and functional parameters of subvalvular structures in healthy children (50 individuals) and children with mitral valve prolapse divided in two groups: first group - without regurgitation (34 children), the second group - with regurgitation (16 children). Results. In healthy children identified were strong correlation links between echocardiographic indices of the subvalvular structures of the mitral valve and the functional parameters of the left ventricle. The diameter of the anterolateral group of papillary muscles directly correlated with the thickness of the interventricular septum, while the diastolic distance between the papillary muscles - with the end diastolic diameter of the left ventricle. It was established that the following factors may contribute to the pathogenesis of mitral valve prolapse: (1) long papillary muscles and the corresponding chords of the valve, (2) a weak (relative to the norm) contractile ability of the papillary muscles, (3) hyperkinesis of the left ventricular apex, and (4) no relationship between the apical and the global ejection fraction. These factors contribute to the fact that the papillary muscles and chords constrain the mitral valve cusps to a lesser extent during systole, which in turn easily bulge into the left atrium under the influence of systolic blood pressure. Apical hyperkinesis contributes to even closer approximation of the subvalvular structures with the cusps. Conclusion. Mitral valve prolapse is attributed to desynchronization of the function of papillary muscles and of the left ventricle; the development of functional mitral regurgitation during mitral valve prolapse is associated with dyssynchrony of the papillary muscles’ activity.

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