The tricuspid valve complex has been studied since the beginning of the twentieth century, and variations in the structural orientation of the tricuspid leaflets has been reported before, as the occurrence of accessory leaflets poses a major problem during surgeries related to the tricuspid valve. In this study, 36 adult formalin-fixed human hearts were analyzed to compare the number, form and size of the tricuspid leaflets. The result shows that in right ventricles, the number of leaflets can vary from the routine three to as many as seven, and the localization of such accessory leaflets of the tricuspid valve differs between specimens. Five leaflet forms were the most common, and the 'typical' form of tricuspid valves with no accessory leaflets was only present in a small percentage of the cases studied. Measurements of the main and accessory leaflets showed that the anterior leaflets were the largest, followed by the inferior leaflets, while the septal and the accessory leaflets were the smallest in size. On the basis of these results, it is suggested that three leaflets of the tricuspid valve are relatively uncommon, with frequent occurrences of accessory leaflets. The multicuspidal form of the tricuspid valve therefore raises concern about understanding the functional and physiological significance of the accessory leaflets.
Introduction Angiosome formed by Anterior tibial artery and dorsalis pedis artery supply the ankle and the dorsum of foot. Both the vessels shows variation in termination and branching pattern.
Materials and Methods 50 free formalin preserved limbs were dissected for the study.
Results and Conclusion Anterior tibial artery showed variation in termination in 16%, most common of them was formation of loop with perforating branch of peroneal artery in 10%, bifurcation in to medial and lateral tarsal artery in 4% and trifutcation in 2%. Branching pattern of dorsalis pedis artey was variable in 18%, medial and lateral tarsal arteries were not branches of dorsalis pedis artery in 14% and 16% respectively. Arcuate artery was absent in 10%, when present it was branch of dorsalis pedis artery in 96%, perforating branch of peroneal artery in 2% and loop of medial and lateral tarsal artery in 2%. First dorsal metatarsal artery was not branch of dorsalis pedis artery in 4%. Lateral tarsal artery was constantly found in all the dissected limbs. Thorough knowledge of variation about branching pattern of arterial tree is clinically important for accuracy in interpretation of angiographs, Doppler study of lower limb vessels and optimum use of vascular pedicle for myocutaneous flaps. Importance of palpation of peripheral pulse in lateral tarsal artery is discussed in the study.
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