The petrous and cavernous parts of internal carotid artery (ICA) are obscure and are not readily accessible to observation/imaging. These parts have broad biological and medical interest because of their peculiar shape. Given the their clinical importance and the scarce data available based mostly on imaging, the present study was aimed at studying these parts of ICA by dissection. The study was carried out on 56 ICAs obtained from embalmed adult cadavers and 10 ICAs from five fetuses. The foetal ICAs were studied in situ. The morphometric analysis of the adult ICA was done after its removal from cranial cavity to gain an insight into the geometry of the vessel, i.e., length, various bends, and diameters at various locations. ICAs in fetuses ran a relatively straighter course taking gentle curves at three positions (two intrapetrous, one cavernous). Adult ICAs were more tortuous and exhibited greater variability in length and angulations. The length of respective portions of the ICA correlate negatively with the measure of angles. The angles in the petrous and cavernous parts were positively correlated to each other. The carotid siphon was positively, highly significantly correlated to other angles. Longer vessels are more tortuous with acute bends. An acute carotid siphon is an indication of more tortuous ICA. The findings of the present study have created a reference data of unsuspected adult population and has potential implications for studying cause/effect relationship of vessel geometry and hemodynamic factors.

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Advancement in imaging techniques and interventional cardiology procedures have generated renewed interest in anatomy of tricuspid valve complex. The purpose of the present study was to characterize the morphology of tricuspid valve leaflets using objective criteria. Thirty-six embalmed cadaveric hearts were utilized for the present study. Leaflet morphology was studied using newly defined criteria. Commissural zones were identified and leaflets were delineated. Presence of scallops was also recorded. Single leaflet was observed in six cases, double in 26 cases, and triple in four cases. The anterior leaflet is large with multiple scallops and frequently accrues portion of inferior leaflet. The septal leaflet is in the form of a plateau and also frequently accrues parts of inferior leaflet. The inferior leaflet rarely occurs as independent leaflet. A wide un-indented basal zone exists across the valve leaflets. The study found that the tricuspid valve is rarely tricuspid. It also generated the hypotheses that the tricuspid valve does not open completely due to presence of a wide basal zone and the valve does not close completely owing to incongruence and lack of coaptation of leaflets. The findings provide clear understanding of leaflet morphology of tricuspid valve. This will help imaging specialists for interpretation of images and cardiologists for interventional procedures. The findings also enhance our understanding of pathophysiology of conditions like functional tricuspid regurgitation.

SUMMARY:The atrioventricular valve is the most commonly repaired valve of the heart. Interventional procedures like annuloplasties, valvotomy/valvuloplasty, repair/replacement of the valve for regurgitation or prolapse are increasing by the day. This necessitates a clear understanding of the mitral valve anatomy. The present study is an attempt to revisit the anatomy of mitral valve. The present study was conducted on 34 adult embalmed heart specimens. Based on the newly defined criteria, observations were made on: 1) Number of commissures and their positions, 2) Number and position of leaflets, 3) Number and position of minor commissures, 4) Annular circumference (AC), 5) Length of annular attachment of each leaflet (LAA), 6) Maximum width of coapted/ folded margin (FM) of the anterior and posterior leaflet, 7) The surface area of each leaflet (SA). The observations were analyzed statistically. The findings of the present study and the subsequent statistical analysis offer a dynamic concept of the anatomy of mitral valve leaflets. It suggests that the valvular anatomy depends upon a complex interplay of various valve components. The extra leaflets tend to occur when annular circumference increases and is not appropriately compensated by various valvular elements. The different methodology adopted in the present study and the interpretations deduced hereupon, shall dispel the existing ambiguities in the description of the leaflets and improve our understanding of the structure and function of the mitral valve complex.