scholarly journals A comparative study of the morphology of mammalian true chordae tendineae of the atrioventricular valves

2015 ◽  
Vol 32 (02) ◽  
pp. 071-077 ◽  
Author(s):  
J. Hutchison ◽  
P. Rea
Keyword(s):  
Tricuspid Valve ◽  
Papillary Muscle ◽  
Papillary Muscles ◽  
Atrioventricular Valve ◽  
Chordae Tendineae ◽  
Atrioventricular Valves ◽  
Abrupt Transition ◽  
Significant Difference ◽  
Cardiac Valve Replacement ◽  
Transition Areas

Abstract Introduction: There is little literature on the subvalvular apparatus of the atrioventricular valves' of the heart. This investigation aimed to compare mammalian atrioventricular valve subvalvular apparatus; in particular the number and characteristics of true chordae tendineae (TChT) and their tissue transition areas - proximally with the valve leaflets, and distally with the papillary muscles. Materials and Methods: Sheep, pig and bovine fresh hearts were dissected (n = 9). The subvalvular apparatus of the mitral and tricuspid valves were visualised. Each TChT origin was grouped and counted according to papillary muscle and valve, and compared within and across the species. Appropriate statistical analyses were then applied to identify any correlations. Histological examination of the transition areas was also performed. Results: The tricuspid valve had significantly more TChT than the mitral (p = 0.04). On comparison of the TChT counts in both valves across the species, there were no signiicant differences. An unexpected inding was the abrupt transition from chordae collagen to papillary muscle. Conclusion: The tricuspid valve is under less pressure than the mitral but is connected to significantly more TChT. We have shown no significant difference between the numbers of TChT for each papillary muscle in either mitral or tricupsid valves across the species. Veterinary teaching emphasises that there is no clinically signiicant difference at a gross morphology level between these species. This is the irst study to report that there is also no signiicant difference at the subvalvular level, and this has direct translational relevance for bioprosthetic cardiac valve replacement.

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. 

Traumatic tricuspid insufficiency in a kitten

1999 ◽  
Vol 35 (1) ◽  
pp. 21-24 ◽  
Author(s):  
JM Closa ◽  
A Font
Keyword(s):  
Pleural Effusion ◽  
Right Ventricle ◽  
Papillary Muscle ◽  
Atrioventricular Valve ◽  
Chordae Tendineae ◽  
Color Flow ◽  
Tricuspid Insufficiency ◽  
Muscle Insertion ◽  
Valve Insufficiency ◽  
The Right

A four-month-old, male, common European kitten developed pleural effusion and ascites after falling from a fourth-floor flat. Radiographic, bidimensional echocardiography and color-flow Doppler findings were compatible with right-sided atrioventricular valve insufficiency. Necropsy confirmed the diagnosis that tricuspid insufficiency resulted from the rupture of the chordae tendineae of the nonseptal cusp of the valve at the level of the cranial papillary muscle insertion in the right ventricle.

Morphological three-dimensional analysis of papillary muscles in borderline left ventricles

2017 ◽  
Vol 27 (7) ◽  
pp. 1369-1376
Author(s):  
Mari N. Velasco Forte ◽  
Mohamed Nassar ◽  
Nick Byrne ◽  
Miguel Silva Vieira ◽  
Israel V. Pérez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricle ◽  
Papillary Muscle ◽  
Three Dimensional ◽  
Papillary Muscles ◽  
Biventricular Repair ◽  
Muscle Morphology ◽  
Significant Difference ◽  
Surgical Options

AbstractObjectiveMitral valve anatomy has a significant impact on potential surgical options for patients with hypoplastic or borderline left ventricle. Papillary muscle morphology is a major component regarding this aspect. The purpose of this study was to use cardiac magnetic resonance to describe the differences in papillary muscle anatomy between normal, borderline, and hypoplastic left ventricles.MethodsWe carried out a retrospective, observational cardiac magnetic resonance study of children (median age 5.36 years) with normal (n=30), borderline (n=22), or hypoplastic (n=13) left ventricles. Borderline and hypoplastic cases had undergone an initial hybrid procedure. Morphological features of the papillary muscles, location, and arrangement were analysed and compared across groups.ResultsAll normal ventricles had two papillary muscles with narrow pedicles; however, 18% of borderline and 46% of hypoplastic cases had a single papillary muscle, usually the inferomedial type. In addition, in borderline or hypoplastic ventricles, the supporting pedicle occasionally displayed a wide insertion along the ventricular wall. The length ratio of the superolateral support was significantly different between groups (normal: 0.46±0.08; borderline: 0.39±0.07; hypoplastic: 0.36±0.1; p=0.009). No significant difference, however, was found when analysing the inferomedial type (0.42±0.09; 0.38±0.07; 0.39±0.22, p=0.39). The angle subtended between supports was also similar among groups (113°±17°; 111°±51° and 114°±57°; p=0.99). A total of eight children with borderline left ventricle underwent biventricular repair. There were no significant differentiating features for papillary muscle morphology in this subgroup.ConclusionsThe superolateral support can be shorter or absent in borderline or hypoplastic left ventricle cases. The papillary muscle pedicles in these patients often show a broad insertion. These changes have important implications on surgical options and should be described routinely.

Nonuniform contraction in the isolated cat papillary muscle

1977 ◽  
Vol 233 (5) ◽  
pp. H613-H616 ◽  
Author(s):  
L. L. Huntsman ◽  
S. R. Day ◽  
D. K. Stewart
Keyword(s):  
Papillary Muscle ◽  
Video Recording ◽  
Muscle Length ◽  
Passive State ◽  
Papillary Muscles ◽  
Cat Papillary Muscle ◽  
Abrupt Transition ◽  
Mechanical Measurements ◽  
Center Region ◽  
Whole Muscle

Microspheres infused into the coronary microcirculation were used as markers to define segments within isolated cat papillary muscles. Video recording and analysis provided measurements of the variations of segment lengths as the muscles contracted at lengths of 76–100% Lmax. In all muscles, segments in the center region were found to shorten during muscle isometric contraction while those in the end regions lengthened. Central shortening was typically 10–15%. In the passive state, segment lengths varied directly with muscle length over a broad range characterized by low force. Segments in the center region, however, displayed an abrupt transition to high stiffness at a certain length while end regions continued to stretch. Force-length relationships obtained for the presumably healthy center segment are significantly different from those obtained for the whole muscle. These results suggest that there may be major difficulties with the interpretation of mechanical measurements on papillary muscles unless contractile inhomogeneity is eliminated or taken into account.

scholarly journals Relationship between papillary muscles abnormalities and apparently unexplained infero-lateral T-wave inversion in athletes

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Bettella ◽  
M De Lazzari ◽  
A Zorzi ◽  
T Vessella ◽  
A Cipriani ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Papillary Muscle ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Control Group ◽  
Papillary Muscles ◽  
Age And Gender ◽  
Significant Difference ◽  
And Gender ◽  
Apical Displacement

Abstract Aims To evaluate by cardiac magnetic resonance (CMR) if left ventricle papillary muscle abnormalities, such as hypertrophy and abnormal location, may be the anatomo-functional substrates responsible for TWI inversion in lateral or infero-lateral leads in otherwise healthy athletes. Methods We included competitive athletes with TWI in lateral or infero-lateral leads in the absence of cardiac diseases detected by CMR. The control population included healthy athletes with normal ECG, matched for age and gender. We compared thickness, volume (both absolute and relative to the cardiac mass) and position of the papillary muscles between cases and controls. Results We included 53 athletes with apparently unexplained TWI in the lateral or infero-lateral leads (median age 20 years (17–42), 86.8% males) and 53 athletes with no TWI matched for age and gender. 4 patients (7.6%) had family history for cardiomyopathy or sudden cardiac death. Athletes with TWI showed more hypertrophic papillary muscles compared to controls, with statistically significant difference in diameter, area and volume (p<0.01). The median ratio between the papillary muscles and the left ventricular mass was 4.4% among athletes with TWI versus 3% among those without TWI (p<0.001). Papillary muscles showed apical displacement in 47% of cases, compared to 17% in the control group (p=0.001). Conclusions Idiopathic TWI in lateral or infero-lateral leads is associated with left ventricle papillary muscle hypertrophy and their apical displacement detected by CMR. The comprehension of clinical and prognostic significance of papillary muscle abnormalities responsible for these ventricular repolarization alterations requires further studies. Example Funding Acknowledgement Type of funding source: None

scholarly journals Comparative Study Between the Papillary Muscles of the Right Ventricle and the Left Ventricle Papillary Muscles

2018 ◽  
Vol 24 (2) ◽  
pp. 77-81
Author(s):  
Tobă Marius ◽  
Iliescu Dan Marcel ◽  
Bordei Petru ◽  
Popescu-Chiriloaie Cristina ◽  
Gheorghiţescu Jancă Ruxandra
Keyword(s):  
Left Ventricle ◽  
Right Ventricle ◽  
Comparative Study ◽  
Upper Extremity ◽  
Papillary Muscle ◽  
Muscle Group ◽  
Ventricular Wall ◽  
Papillary Muscles ◽  
Chordae Tendineae ◽  
The Right

Abstract We used formalinized heart dissection obtained from forensic laboratory in Constanta, analyzing the papillary muscles and their tendon chordae. We studied at the papillary muscles the number of forms that could be in single or multiple muscular bodies, encountering more than five body muscles in a papillary muscle group. We measured using caliper graduated in millimeters, the height of each papillary muscle body (from the base to its upper end) and its thickness at the base and at its upper extremity. Chordae tendon we examined in terms of their origin and number at the level of each papillary muscle, the dimensions (length and thickness), orientation and how they end at the atrioventricular valves. We noted the presence of „false”chordae tendineae, which were disposed between the papillary muscle and the ventricular wall. The results were compared with data in the literature that I had the opportunity to consult

scholarly journals Biomimetic six-axis robots replicate human cardiac papillary muscle motion: pioneering the next generation of biomechanical heart simulator technology

2020 ◽  
Vol 17 (173) ◽  
pp. 20200614
Author(s):  
Annabel M. Imbrie-Moore ◽  
Matthew H. Park ◽  
Michael J. Paulsen ◽  
Mark Sellke ◽  
Rohun Kulkami ◽  
...  
Keyword(s):  
Papillary Muscle ◽  
Degrees Of Freedom ◽  
Ex Vivo ◽  
Robotic System ◽  
Papillary Muscles ◽  
Chordae Tendineae ◽  
Six Degrees Of Freedom ◽  
Reachable Workspace ◽  
Computed Tomography Images ◽  
Force Profile

Papillary muscles serve as attachment points for chordae tendineae which anchor and position mitral valve leaflets for proper coaptation. As the ventricle contracts, the papillary muscles translate and rotate, impacting chordae and leaflet kinematics; this motion can be significantly affected in a diseased heart. In ex vivo heart simulation, an explanted valve is subjected to physiologic conditions and can be adapted to mimic a disease state, thus providing a valuable tool to quantitatively analyse biomechanics and optimize surgical valve repair. However, without the inclusion of papillary muscle motion, current simulators are limited in their ability to accurately replicate cardiac biomechanics. We developed and implemented image-guided papillary muscle (IPM) robots to mimic the precise motion of papillary muscles. The IPM robotic system was designed with six degrees of freedom to fully capture the native motion. Mathematical analysis was used to avoid singularity conditions, and a supercomputing cluster enabled the calculation of the system's reachable workspace. The IPM robots were implemented in our heart simulator with motion prescribed by high-resolution human computed tomography images, revealing that papillary muscle motion significantly impacts the chordae force profile. Our IPM robotic system represents a significant advancement for ex vivo simulation, enabling more reliable cardiac simulations and repair optimizations.

A cadaveric study on chordae tendinae of human tricuspid valve

2021 ◽  
Vol 8 (3) ◽  
pp. 226-229
Author(s):  
Chandragirish S ◽  
Harsha B R ◽  
Girish V Patil
Keyword(s):  
Tricuspid Valve ◽  
Papillary Muscle ◽  
Human Heart ◽  
Free Edge ◽  
Papillary Muscles ◽  
Post Mortem ◽  
Valve Diseases ◽  
Anterior Papillary Muscle ◽  
Modern Technologies ◽  
Formalin Fixed

Aim of the present study was to observe the types of chordae tendinae present in tricuspid valve of human heart. Morphology of chordae tendinae in tricuspid valve gains utmost importance in cardiac surgeries in recent times because advent in modern technologies in treatment of tricuspid valve diseases.This study was carried out on 96 normal formalin fixed human post-mortem heart specimens. Types of chordae tendinae observed on the basis of their attachments.Chordae tendinae were observed in all specimens. Five types of chordae tendinae were identified namely rough zone, free edge, fan shaped, deep and basal chordae. Anterior papillary muscle was seen providing attachment to 2 to 9; Posterior papillary muscles were seen with 1 to 6 and Septal papillary muscles provided attachment to 1 to 4 chordae tendinae.We hope this study will serve to understand the tricuspid valve complex and types of different chordae tendinae better and it will help in various surgical procedures done on tricuspid valve.

Abstract 314: Sensory Innervation of the Papillary Muscle: A Neural Link Between Mitral Valve Prolapse and Malignant Ventricular Arrhythmias?

2016 ◽  
Vol 119 (suppl_1) ◽  
Author(s):  
Krishan J Patel ◽  
Olujimi A Ajijola ◽  
Michael Fishbein ◽  
Kalyanam Shivkumar
Keyword(s):  
Mitral Valve ◽  
Papillary Muscle ◽  
Mitral Valve Prolapse ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Sensory Innervation ◽  
Papillary Muscles ◽  
Neuronal Marker ◽  
Significant Difference ◽  
Afferent Innervation

Background: Malignant mitral valve prolapse (MVP) identifies a subset of patients with MVP associated with ventricular arrhythmias (VAs), including sudden cardiac death (SCD). We hypothesized that papillary muscles, which see significant mechanical stress in MVP, are richly innervated with sensory nerves, which induce severe autonomic imbalance on the heart and may trigger malignant VAs. Methods and Results: Longitudinal sections of the anterior and posterior left ventricular papillary muscles, right ventricular outflow tract (RVOT), ventricular septum, and basolateral left ventricular wall (LV) of Yorkshire pigs (n=8) were excised, formalin-fixed, paraffin-embedded, and sectioned. Immuno-staining for protein gene product 9.5 (PGP9.5), a pan-neuronal marker, and calcitonin-gene related peptide (CGRP), a sensory afferent neuron marker, was performed. Areas of immunoreactivity (IR) for CGRP were verified by direct comparison to PGP9.5 IR. The density of CGRP was then compared across anatomical regions. The mean CGRP IR area was 1229.44 ± 116.65 μm 2 /nucleus in papillary muscles, while in the septum, basolateral LV, and RVOT, the CGRP stained areas were 699.36 ± 88.28 μm 2 /nucleus, 681.51 ± 81.90 μm 2 /nucleus, and 381.98 ± 31.14 μm 2 /nucleus, respectively (p<0.001). There was no significant difference between CGRP IR area in the anterior papillary muscle (1091.36 ± 189.82 μm 2 /nucleus) and the posterior papillary muscle (1347.79 ± 140.50 μm 2 /nucleus) (p>0.3). Conclusions: There is a significantly greater amount of afferent innervation in the papillary muscle compared to the septum, basolateral LV, and RVOT. This enrichment of afferent innervation warrants further study to understand how afferent neurotransmission during abnormal mitral valve function may impact ventricular electrophysiology.

scholarly journals Study of the cardiac left atrioventricular valvar complex in water buffaloes (Bubalus bubalis) of the Jafarabadi breed

2009 ◽  
Vol 29 (10) ◽  
pp. 852-858
Author(s):  
Patrícia R. Esteves ◽  
Karla P.C. Araújo ◽  
Carlos E. Ambrósio ◽  
Dulcinéa G. Teixeira ◽  
Daniele S. Martins ◽  
...  
Keyword(s):  
Papillary Muscle ◽  
Heart Diseases ◽  
Bubalus Bubalis ◽  
Papillary Muscles ◽  
Atrioventricular Valve ◽  
Adult Males ◽  
Water Buffaloes ◽  
The Third ◽  
Brazilian State

Atrioventricular valve complex of 30 Jafarabadi water buffaloes, adult males were studied in this research with no heart diseases. The animals were obtained from a slaughterhouse in Brazilian State of Parana. The hearts were opened at the third portion affording access to the valve complex. The complexes had its area, number and type of tendinous cords submitted to analysis. The results showed that the complex is composed by two cusps and four accessory cusps, two or three papillary muscles in which 10-25 tendinous cords fix on the cusps that face the ventricle wall. The total area of the complex was on average 38.56cm², with a minimum of 24.96cm² and a maximum of 55.54cm². Statistically, no relation between the number of cords and the cusps' area where they are inserted or with the number of papillary muscle where they originated from was observed.

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